Modern Mafia in Italy.  
The incarcerated bosses are subject to strict controls on their contact with the outside world, limiting their ability to run their operations from behind bars under the article 41-bis prison regime. Antonino Giuffrè is a close confidant of Provenzano who turned informant shortly after his capture in 2002. He alleges that Cosa Nostra had direct contact in 1993 with representatives of Silvio Berlusconi who was then planning the birth of Forza Italia.  
The alleged deal included a repeal of 41-bis, among other anti-Mafia laws, in return for electoral support in Sicily. Nevertheless, Giuffrè's declarations have not yet been confirmed. The Italian Parliament reinforced the provisions of the 41-bis, with the full support of Forza Italia. When the bill was set to expire in 2002, it was made into a permanent fixture in the penal code and extended to other crimes such as terrorism. However, according to one of Italy's leading magazines L'Espresso, 119 mafiosi have been released on an individual basis – one-fifth of those incarcerated under the 41-bis regime. The human rights group Amnesty International expressed concern that the 41-bis regime could, in some circumstances, amount to "cruel, inhumane or degrading treatment" for prisoners.  
In 2015, the Mafia Capitale investigation revealed that the Mafia profits from the European migrant crisis and exploits refugees.  
In October 2017, members of the Renzvillo crime family and 2 Carabinieri military police officers were arrested for involvement in the drug trade and large-scale extortion. Altogether 37 people were arrested and over 600 officers were deployed. €11 million ($12 million) in real estate and goods were seized by police. A business owner was forced to pay €180,000 ($212,000). The Renzvillo mafia family has allegedly set up alliances with the 'Ndrangheta and Camorra. The leader is suspected of previously sending members of his organization to Karlsruhe and Cologne in Germany.  
On 22 January 2018, 58 people connected to 16 mafia families were arrested by Carabinieri police in Caltanissetta, Palermo, Enna, Ragusa, Agrigento and Catania. Some of the most common charges were mafia association, drug trafficking, extortion, fraud, and vote buying.  The mayor of San Biagio Platani, Santino Sabella, was among the arrested and accused of agreeing on candidates for the 2014 local elections with the Sicilian Mafia and exerting pressure on the allocation of council contracts. Two companies running migrant reception centers in Sicily were targeted as protection rackets, overall 27 businesses were targeted and extorted.  
On 1 February 2018, 31 people with ties to a crime family based in Palermo were arrested and charged with money laundering, fraud and drug trafficking, as part of Operation "Game Over".  Benedetto Bacchi, reportedly controlled over 700 betting shops across Italy and was earning roughly €1 million per month, using an online gambling operator licensed in Malta; his license was suspended. According to investigators, Bacchi bought a construction company, and a villa formerly owned by footballer Giovanni Tedesco for €500,000; the next day Bacchi listed the house for sale at the price of €1.3 million. He also allegedly considered taking over a news publication with his criminal proceeds. Investigators also alleged that the American Mafia in New York had set up a profitable food export company with the Sicilian mafia.  
The Cosa Nostra has traditionally been the most powerful group in Palermo. After the arrest of the alleged new mafia boss in July 2019, a CNN article in July 2019 indicated that Sicilian Mafia activity in Palermo was particularly notorious in one area: the Sicilian town of Passo di Rigano with involvement "in business such as wholesale food supplies, online betting and gambling".  News articles also confirmed links between the Cosa Nostra and New York's Gambino crime family. According to Italian newspaper La Repubblica, "Off they go, through the streets of Passo di Rigano, Boccadifalco, Torretta and at the same time, Brooklyn, Staten Island, New Jersey. Because from Sicily to the US, the old mafia has returned."  
Murders, particularly ones connected to Mafia activity, have decreased considerably since the 1990s. In 1991, there were 481 murders in Sicily of which 253 were connected to Mafia activity. In 2020, there were only 33 murders of which 4 were Mafia murders.  

Structure and composition.  
Cosa Nostra is not a centralized organization but rather a loose confederation of about one hundred groups known alternately as "families", "cosche", "borgatas", or "clans" (despite the name, their members are generally not related by blood). Each of these claims sovereignty over a territory, usually a town or village or a neighborhood of a larger city, though without ever fully conquering and legitimizing its monopoly on violence. For many years, the power apparatuses of the single families were the sole ruling bodies within the two associations, and they have remained the real centers of power even after superordinate bodies were created in the Cosa Nostra beginning in the late 1950s (the Sicilian Mafia Commission).  

Clan hierarchy.  
In 1984, mafioso informant Tommaso Buscetta explained to prosecutors the command structure of a typical clan. A clan is led by a "boss" (capofamiglia or rappresentante) who is aided by an underboss (capo bastone or sotto capo) and supervised by one or more advisers (consigliere). Under his command are groups (decina) of about ten "soldiers" (soldati, operai, or picciotti). Each decina is led by a capodecina.  
The actual structure of any given clan can vary. Despite the name decina, they do not necessarily have ten soldiers but can have anything from five to thirty. Some clans are so small that they don't even have decinas and capodecinas, and even in large clans, certain soldiers may report directly to the boss or underboss.  
The boss of a clan is typically elected by the rank-and-file soldiers (though violent successions do happen). Due to the small size of most Sicilian clans, the boss of a clan has intimate contact with all members and doesn't receive much in the way of privileges or rewards as he would in larger organizations (such as the larger Five Families of New York). His tenure is also frequently short: elections are yearly, and he might be deposed sooner for misconduct or incompetence.  
The underboss is second in command to the boss. The underboss is sometimes a family member, such as a son, who will take over the family if the boss is sick, killed, or imprisoned.  
The consigliere ("counselor") of the clan is also elected on a yearly basis. One of his jobs is to supervise the actions of the boss and his immediate underlings, particularly in financial matters (e.g. preventing embezzlement). He also serves as an impartial adviser to the boss and mediator in internal disputes. To fulfill this role, the consigliere must be impartial, devoid of conflict of interest and ambition.  
Other than its members, Cosa Nostra makes extensive use of "associates". These are people who work for or aid a clan (or even multiple clans) but are not treated as true members. These include corrupt officials and prospective mafiosi. An associate is considered by the mafiosi nothing more than a tool, someone that they can "use", or "nothing mixed with nil".  
The media has often made reference to a capo di tutti capi or "boss of bosses" that allegedly "commands all of Cosa Nostra". Calogero Vizzini, Salvatore Riina, and Bernardo Provenzano were especially influential bosses who have each been described by the media and law enforcement as being the "boss of bosses" of their times. While a powerful boss may exert great influence over his neighbors, the position does not formally exist, according to Mafia turncoats such as Buscetta. According to Mafia historian Salvatore Lupo "the emphasis of the media on the definition of a "capo di tutti capi" is without any foundation". 


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