The U.S. team played two-thirds of the match against the World Champions a man down, as midfielder Ricardo Clark was given a red card for a hard tackle in the 33rd minute. Many observers believed it should have been a yellow caution - including U.S. Coach Bob Bradley.
"It seemed harsh," said Bob Bradley. "And you know, to me it's probably more yellow. And to have to play that period of time down a man against a team like Italy is difficult."
U.S. defender Jay DeMerit elaborated.
"Against a team like that, it's really hard to play it [the game] with 11 men, let alone 10," said Jay DeMerit. "And you know when the midfield opens up like that, you know guys get free. It makes it really hard for us to make the right decisions."
Despite being shorthanded, it was the Americans who scored first, with captain Landon Donovan converting a penalty kick in the 41st minute after teammate Jozy Altidore was taken down in the box.
Italian coach Marcello Lippi said through an interpreter that he did not speak any magic words to his team at halftime. He said his players just did what they needed to do to recover from the 1-0 deficit.
"I do feel that in the second half we played with greater lucidity, greater peace of mind," said Marcello Lippi. "We got the ball to go around [spread it throughout the players and the field]. And you know, we won. But it wasn't easy."
The Italians finally got the equalizer from Giuseppe Rossi in the 58th minute, on a long range blast shortly after he entered as a substitute.
Fourteen minutes later, the Italians took the lead on another long shot from outside the area - this time by Daniele De Rossi.
De Rossi, who was named "Man of the Match," said through an interpreter that there was tension and nervousness among his teammates when the United States had the lead, but that they stayed composed.
"Strangely enough, and we said this to ourselves, our team partners; we said that there was peace of mind because we knew that we could and we had to win that game," said Giuseppe Rossi. "And it wasn't only on the account of our technical skills and capabilities, but it was the bond that has kept us together over the years."
Giuseppe Rossi added the final goal in the fourth and last minute of stoppage time to give the Italians the 3-1 victory.
In an exciting Group B game played earlier on Monday in Bloemfontain, Brazil got a successful penalty kick from Kaka in the 90th minute to edge Egypt, 4-3. On Thursday, Egypt will play Italy in Johannesburg, and the United States will take on Brazil here in Pretoria.