Italian anti-mafia police have arrested Sicilian mafia boss Matteo Messina Denaro, ending a 30-year manhunt for Italy's most wanted fugitive.

A trigger man who once reportedly boasted he could "fill a cemetery" with his victims, the 60-year-old Messina Denaro was a leading figure in Cosa Nostra, the real-life Sicilian crime syndicate depicted in the Godfather movies.

The mobster was nabbed "inside a health facility in Palermo, where he had gone for therapeutic treatment", special operations commander Pasquale Angelosanto said in a statement released by the police.

He had been in the clinic for a year, undergoing periodic treatment for colon cancer under a false name, and did not resist arrest, ANSA news agency said.

Criminology expert Anna Sergi at the University of Essex said Messina Denaro was "the last one, the most resilient one, the 'purest' Sicilian mafioso remaining".

"The secrets he is said to keep fuel conspiracies around mafia-state agreements in the 1990s," she told AFP.

"He is the essence of the great historical power of Cosa Nostra. The myths around his period on the run are part of the reason why the Mafia myth endures."

Prime Minister Giorgia Meloni said Messina Denaro was the "most significant" mafia boss and his arrest in his native Sicily was a "great victory" for the state in its war against organised crime.

A photograph released by police showed Messina Denaro in the back seat of a vehicle, wearing a cream hat, sunglasses and a brown leather jacket with a cream sheepskin lining.

Before that, the only known photo of him dated back to the early 1990s. He had been on the run since 1993.

Messina Denaro was arrested a day after the 30th anniversary of the arrest of Salvatore "The Beast" Riina, the Cosa Nostra boss who died in 2017.

He had been number one on Italy's most-wanted list, accused of mafia association, multiple murders and use of explosives.

Messina Denaro is suspected to have been behind the 1993 bombings in Rome, Milan and Florence that killed ten people, just months after Cosa Nostra murdered anti-mafia judges Giovanni Falcone and Paolo Borsellino in similar attacks.

The arrest of "an extremely dangerous fugitive" was "an extraordinary day for the state", Interior Minister Matteo Piantedosi said.

In 2015, police discovered Messina Denaro was communicating with his closest collaborators via the pizzini system, where tiny, folded paper notes were left under a rock at a farm in Sicily.

Investigators spent decades searching the homes and businesses of the boss's known allies on the island.

They looked in particular for hiding places in grottoes, caverns or even bunkers inside buildings where the man nicknamed "Diabolik" could be concealed.

Ruthless boss of the Sicilian Mafia

Messina Denaro was the undisputed leader of the Cosa Nostra in the Trapani province of western Sicily, but his power extended further, including to the capital Palermo, where he was arrested.

A fan of Rolex watches and designer clothes -- as well as comic books and video games -- he had a reputation as a playboy, and was once featured on an Italian magazine cover in dark glasses, looking like a rock star.

Born on 26 April 1962, in Castelvetrano, in southwest Sicily, Messina Denaro grew up in the heart of organised crime.

His father, Don Ciccio, was the head of the local clan and his godfather was also a member of the mob.

His first run-ins with the law began in 1989, when he took part in a bloody struggle between two clans.

He was accused that year of murdering Nicola Consales, a hotel owner who complained to an employee of always having "these little mafiosos under our feet".

Unfortunately, the employee was Messina Denaro's mistress.

In 1992, he was part of a mob group sent to Rome to try and kill anti-mafia judge Giovanni Falcone.

The group was eventually recalled by Toto Riina, the Corleone boss dubbed "the Beast", who decided on another approach. Falcone was murdered in a car bomb near Palermo on 23 May 1992.

Messina Denaro himself was ruthless throughout his career.

In July 1992, after taking part in the murder of Vincenzo Milazzo, the head of the rival Alcamo clan, he murdered the latter's partner, who was three months pregnant.

The two bodies were buried in the countryside.

As head of the Castelvetrano clan, he was allied to the Corleonesi clan, who were immortalised in the legendary "The Godfather" films.

After Riina was arrested in January 1993, Messina Denaro continued his strategy of all-out terror, providing logistical support to bombings in Florence, Milan and Rome that year.

In November 1993, a court later found, he was one of the organisers of the kidnapping of Giuseppe Di Matteo, then 12, whose father had given testimony about the murder of Falcone.

In one of the most notorious Cosa Nostra incidents, the boy was held for 779 days before being murdered and his body dissolved in acid.

Messina Denaro had disappeared from public view in the summer of 1993, beginning what would be 30 years on the run from accusations including mafia association, murder, theft and possession of explosives.

In 1994 and 1996, statements from mobsters who turned state witness shed some light on his role within Cosa Nostra.

In 2000, after a maxi-process against the Sicilian Mafia in Trapani, he was sentenced in absentia to life imprisonment.

He had numerous sources of revenue, from drug trafficking to gambling, both in Italy and abroad.
In 2015, an Italian prosecutor on his trail, Teresa Principato, said he had likely eluded capture for so long because he was protected "at a very high level".

She did not say whether this meant Cosa Nostra, politicians or institutions.

"We have confirmation of his presence in Brasil, Spain, Britain, Austria. He travels for extremely high-level business, and his return to Sicily is irregular and increasingly infrequent," she told Il Fatto Quotidiano daily at the time.

In 2020, several of Messina Denaro's collaborators were arrested, tightening the net around the boss.
And in October that year, he was again sentenced in absentia for his role in Falcone's murder.