Most Primitivo is grown in Apulia, a coastal region known as the “heel” of Italy, and it is estimated to be the country’s 12th most widely planted grape variety. The main three DOC areas are Primitivo di Manduria, Gioia del Colle Primitivo (Riserva) and Falerno del Massico Primitivo (Riserva o Vecchio). The Manduria DOC covers still red wine as well as sweet (Dolce Naturale) and fortified (Liquoroso Dolce Naturale, Liquoroso Secco) wine. Falerno requires a minimum of 85% Primitivo; the others are 100% Primitivo. Gioia del Colle Rosso and Rosato contain 50–60% Primitivo, and Cilento Rosso/Rosato contains around 15%.
Historically, the grape was fermented and shipped north to Tuscany and Piedmont, where it was used as a blending grape to enhance the body of thin red wines produced in those areas. When the link between Primitivo and Zinfandel began to emerge, plantings in the region and production of non-blended varietal increased. Today most Italian Primitivo is made as a rustic, highly alcoholic red wine with up to 16% alcohol by volume (ABV). Some Italian winemakers age the wines in new American oak to imitate American-style Zinfandel.