Updated 11.30am

Sicilian Mafia boss Matteo Messina Denaro, captured in January after three decades on the run, died on Monday in hospital in central Italy.

The 61-year-old had been treated for colon cancer while detained in a high-security jail in L'Aquila but was moved last month to hospital after his condition deteriorated.

L'Aquila mayor Pierluigi Biondi confirmed the mobster's death in hospital "following a worsening of his illness".

His death "puts the end to a story of violence and blood", Biondi told the ANSA news agency. He thanked prison and hospital staff for their "professionalism and humanity".

It was "the epilogue of an existence lived without remorse or repentance, a painful chapter in the recent history of our nation".

Messina Denaro was one of the most ruthless bosses in Cosa Nostra, the real-life Sicilian crime syndicate depicted in the Godfather movies.

He was convicted of involvement in the murder of anti-Mafia judges Giovanni Falcone and Paolo Borsellino in 1992 and in deadly bombings in Rome, Florence and Milan in 1993.

One of his six life sentences was for the kidnapping and subsequent murder of the 12-year-old son of a witness in the Falcone case.

"No-one should be denied prayers. But I cannot say I'm sorry," Deputy Prime Minister Matteo Salvini said on social media of the mobster's death.

'Irreversible'

Messina Denaro disappeared in the summer of 1993 and spent the next 30 years on the run as the Italian state cracked down on the Sicilian mob.

But he remained the top name on Italy's most-wanted list and increasingly became a figure of legend.

It was his decision to seek treatment for his cancer that led to his capture. He was arrested on January 16, 2023, when he visited a health clinic in Palermo.

He was jailed in L'Aquila, where he continued treatment in his cell, but was moved to hospital in August, under heavy security.

The last picture of Italy's top wanted mafia boss, Matteo Messina Denaro in Palermo, following his arrest in his native Sicily after 30 years on the run. Photo: AFP

Since Friday night, he had been reported to have been in an "irreversible coma". Medics had stopped feeding him and he had asked not to be resuscitated, Italian media reports said.

His arrest may have brought some relief for his victims but the mob boss always maintained his silence.

In interviews in custody after being arrested, Messina Denaro even denied he was a member of the Cosa Nostra.

Wiretaps

After Messina Denaro went on the run, there was intense speculation that he had gone abroad -- and he probably did.

But in the end, he was found to have been staying near his hometown of Castelvetrano in western Sicily.

Castelvetrano mayor Enzo Alfano said he hoped the "suffocating cloud" hanging over his town would now lift.

"It will take decades to eradicate the mentality, the sometimes rampant culture of lawlessness, of impunity" that Messina Denaro "cultivated for so long", he said.

The family house of arrested mafia boss Matteo Messina Denaro is pictured on January 20, 2023. Photo: AFP

Preparations are already under way for the mobster's burial in the family tomb in the town, alongside his father, Don Ciccio, according to the Corriere della Sera newspaper.

Don Ciccio was also head of the local clan. He was said to have died of a heart attack while on the run, his body left in the countryside, dressed for the funeral.

Investigators had been combing the Sicilian countryside for Messina Denaro for years, searching for hideouts and wiretapping members of his family and his friends.

They were heard discussing the medical problems of an unnamed person who suffered from cancer, as well as eye problems -- a person who detectives became sure was Messina Denaro.

They used a national health system database to search for male patients of the right age and medical history, and eventually closed in.