In the light of Italy's current economic stagnation, characterized by mass unemployment, especially in the south, the development of effective energy policies should be seen as an opportunity of reducing energy dependency, so as to increase competitiveness and sustainability. However, due to imbalances in development in the country, focus at the national level does not reveal particular characteristics of the different regions. In this context, the definition of specific energy actions should be based on information and analyses that refer to integrated and multi-level perspectives, such as regional and sectoral levels. Here we investigate, by applying a multi-scale integrated analysis of societal metabolism approach, the imbalanced nature of development, coupled with energy consumption, of two Italian regions, Veneto (northern Italy) and Abruzzo (southern Italy). Changes over time (1995–2007), related to both socio-economic and biophysical indicators, are analysed at multiple levels: region, economic sectors, and production and consumption. The results show that different structural changes and challenges are needed to meet energy efficiency, depending on the diverse level of regional development. They provide support for the future development of effective Regional Energy Plans, as well as to identify potential local barriers to achieving regional competitiveness and sustainability. Copyright © 2012 John Wiley & Sons, Ltd and ERP Environment.