Between June 2006 and August 2007, two measles outbreaks occurred in the Lazio region. The first outbreak (June-December 2006) initially involved the Roma/Sinti population, and subsequently spread to the rest of the population. The second outbreak overlapped with the first (October 2006-August 2007) and affected mainly the Italian adolescent and adult population. In this article we describe the two outbreaks and highlight the importance of pockets of low vaccine coverage in sustaining such outbreaks. Data from the mandatory infectious diseases surveillance system, field epidemiological investigations, and molecular characterization of measles virus by the national reference laboratory are presented.