Italy scored four tries in a second-half fightback to triumph 38-17 and shatter Uruguay’s hopes of a shock victory in a pulsating Pool A encounter at Stade de Nice.
Winger Lorenzo Pani gave Italy an early lead, but after second-row Niccolo Cannone was yellow carded, Uruguay levelled from a penalty try that saw prop Danilo Fischetti join his team-mate in the sin-bin.
Uruguay used the two-man advantage to send wing Nicolas Freitas over. Felipe Etcheverry added a drop goal to give his side a 17-7 half-time lead which would have been greater had the fly-half not missed two early penalty attempts.
But three tries within 10 minutes from skipper Michele Lamaro, Montanna Ioane and Lorenzo Cannone - the first two after Andres Vilaseca was yellow carded - sealed a bonus point. Juan Ignacio Brex added a fifth as Italy made it two wins out of two.
Italy captain Michele Lamaro, named the Mastercard Player of the Match, was delighted to emerge victorious after a tough first half for the Azzurri.
"This is a real group, we're a family," he said. "It was a really tough game. I told all the Uruguayan guys they can be proud of their performance, they put us under a lot of pressure but in these moments, what counts the most is how strong the team is and in the second half we showed that and smashed everything we could.
"I'm really proud of the boys and I'll share this moment with them for the rest of my life."
Kieran Crowley lamented his side’s “untidy” first-half display but praised their response.
“Our discipline let us down, we had seven turnovers inside our own 40, you can't do that,” he said.
“Uruguay put the pressure on us and made us pay. So we went in at half-time and said we needed to hold on to the ball, be direct. The boys did that really well and scored some good tries. It was pleasing in the end but nerve-wracking earlier."
Uruguay flanker Santiago Civetta said his side, ranked number 17 in the World Rugby rankings, had targeted this match as an opportunity to seal qualification for Rugby World Cup 2027 against 12th-ranked Italy.
“It was a really epic battle," he said. "We gave the best we could. There were lot of mistakes, more than what we wanted, and Italy exploited those errors. They were better than us.
“It is quite frustrating to be honest. We dreamt really big about this match. Big dreams sometimes come true, sometimes they don’t. We need to keep on working. We have two more matches and we have to prepare them well.”
Head coach Esteban Meneses added: "We came here to make history but Italy played very well in the second half, so congratulations to them.
“Our target was Italy and Namibia. It was a very tough match but the second step is Namibia and we will prepare very well for that match now.”