The presence of organized crime strongly affects sustainable waste management in Italy. In particular, illegal trafficking of waste has become one of the fastest growing areas of crime and one of the most lucrative industries among organized criminal activities, which has now infiltrated both the Italian urban and hazardous waste management cycle. In this study, we aim to investigate the determinants of the illegal trafficking of waste using waste, economic, and enforcement data in a panel analysis over the period 2002-2013. The topic is particularly relevant, given the high heterogeneity across Italian regions which also relates, and eventually leads, to different environmental performances. Our main findings reveal that, in most Italian regions, enforcement activities do not exert a significant deterrence on criminal behaviors; a negative relationship between enforcement and illegal trafficking of waste can be identified only for very high levels of enforcement efforts. Moreover, we find that the major determinants influencing the rate of illegal trafficking of waste differ between northern-central and southern regions, confirming the existence of a regional dualism. In particular, while in the northern-central area the crime rate is positively related to the level of education and negatively to the adoption of environmentally sound policies, in southern regions the organized activities for illegal trafficking are negatively related to the degree of education attainment and positively to the endowment of waste management plants.