Stymied by Sweden, Italy to miss World Cup for 1st time in 60 years
Stunned 1-0 by the Swedes in the first leg in Stockholm, the Italians pressed from start to finish in front of 74,000 spectators at Milan's San Siro stadium.
The four-time World Cup champions dominated possession and generated plenty of chances, but couldn't find the back of the net.
For Sweden, the upset means a return to the World Cup after 12 years of failing to qualify.
Monday's match was the last international appearance for veteran Italian goalkeeper Gianluigi Buffon, a key element of the side who won the World Cup in 2006.
The 39-year-old said ahead of the clash that he would be retiring from international play if the Azzurri didn't qualify for next year's World Cup in Russia.
Italy's defeat destroyed Buffon's chance to play in what would have been a record sixth World Cup.
The match began with high intensity and the first 13 minutes saw the referee issue yellow cards to Italy's Giorgio Chiellini and Swede Jakob Johansson, the goal scorer in the first leg.
More consequentially, chief official Mateu Lahoz let each side get away with fouls, a pattern that was to continue for the rest of the game.
There was no call when Sweden's Ludwig Augustinsson brought down Marco Parolo in the box in the 8th minute, or four minutes when Italy's Matteo Darmian committed a clear handball.
The hosts' best chance of the first half belonged to Ciro Immobile, whose shot was turned aside by Swedish keeper Robin Olsen.
Alessandro Florenzi fired just wide for the Azzurri soon after the re-start and the post saved Sweden's Mikael Lustig from an own goal.
Italy grew increasingly frantic as the clock ran down, with Buffon coming forward on the corners in the desperate quest for a goal to send the match into extra time.
But Sweden withstood the onslaught to complete the upset.