An operating device for a tilt and turn door or window comprising at least a fixed frame and a movable sash connected to each other along a corresponding vertical upright (4, 5) by a pair of hinges, a lower hinge and an upper hinge, and a control handle positioned on the upright of the sash opposite to that connected to the fixed frame; the operating device comprising at least: - a slider for transmitting the movement of the handle adapted to be housed and slidable inside a groove of an upper crosspiece of the sash; - a positioning body fixable in the groove of the upper crosspiece; the body having a slot with a longitudinal operating extension; - a connecting arm adapted to be articulated, at a first end, to the movable portion of the upper hinge and articulated, at the other end, to the positioning body by means of a pin housed in the slot of the positioning body; the arm having a relative surface provided with at least two elements (17, 18) protruding towards the groove and a free zone, spaced from each other along the arm; - a selector element connected to the slider, slidable inside the groove of the upper crosspiece for intercepting, according to a sequence predetermined by the relative position of the protruding elements (17, 18) and the free zone, the protruding elements (17, 18) and free zone, in such a way as to define corresponding closed, turning opening and tilted open configurations which can be adopted by the movable sash, the device being characterised in that it comprises at least one of the protruding elements (17, 18) provided with removable positioning means acting between at least one of the protruding elements (17, 18) and the connecting arm for modifying the position of the protruding element relative to the other protruding element, along the arm, in such a way as to vary the sequence of configurations which can be adopted by the movable sash and wherein the connecting arm is equipped with the other protruding element, fixed to the connecting arm, and at least two through holes (22, 23), spaced from each other, forming a housing seat of the protruding element equipped with the removable positioning means and, respectively, the free zone, or vice versa. - a slider for transmitting the movement of the handle adapted to be housed and slidable inside a groove of an upper crosspiece of the sash; - a positioning body fixable in the groove of the upper crosspiece; the body having a slot with a longitudinal operating extension; - a connecting arm adapted to be articulated, at a first end, to the movable portion of the upper hinge and articulated, at the other end, to the positioning body by means of a pin housed in the slot of the positioning body; the arm having a relative surface provided with at least two elements (17, 18) protruding towards the groove and a free zone, spaced from each other along the arm; - a selector element connected to the slider, slidable inside the groove of the upper crosspiece for intercepting, according to a sequence predetermined by the relative position of the protruding elements (17, 18) and the free zone, the protruding elements (17, 18) and free zone, in such a way as to define corresponding closed, turning opening and tilted open configurations which can be adopted by the movable sash, the device being characterised in that it comprises at least one of the protruding elements (17, 18) provided with removable positioning means acting between at least one of the protruding elements (17, 18) and the connecting arm for modifying the position of the protruding element relative to the other protruding element, along the arm, in such a way as to vary the sequence of configurations which can be adopted by the movable sash and wherein the connecting arm is equipped with the other protruding element, fixed to the connecting arm, and at least two through holes (22, 23), spaced from each other, forming a housing seat of the protruding element equipped with the removable positioning means and, respectively, the free zone, or vice versa.