Geothermal plants have been producing power in Italy for more than a century. Since local opposition to geothermal development is often fuelled by incomplete and inaccurate environmental information, this paper provides a comprehensive description of the effect of geothermal development on the air, water and soil and investigates potential disturbance from noise, subsidence, and seismicity, as well as the visual impact on the local area. After discussing the risks associated with the geothermal development and the reference data, the paper describes the wide-reaching environmental monitoring and mitigation measures in Italy that have maintained impact values below the thresholds defined by European and Italian regulation. The social benefits for areas where geothermal energy is developed are also described, with the aid of case studies highlighting that citizens do not feel that they are sufficiently informed to have a voice in the innovation process. A regular and comprehensive review of the geothermal environmental and safety regime, as the one carried out in this paper, and a mutual exchange of knowledge between the different stakeholders should be strongly encouraged.