Italians are voting Sunday in run-off mayoral elections in several cities but all eyes are on Rome, where a victory for the eurosceptic Five Star Movement (M5S) would be a blow to Prime Minister Matteo Renzi.

Virginia Raggi, a 37-year-old lawyer and the anti-establishment M5S' candidate in Rome, could become the first woman to lead the city council.

Raggi is pitted against Roberto Giachetti of Renzi's Democrats (PD).

In the first round two weeks back, Raggi led with a little more than 35 per cent of votes, while Giachetti was just short of 25 per cent.

These elections are considered an important test for Renzi, who has repeatedly stressed that they are only representative of local issues and not the national government as a whole.

Mayoral run-off polls are taking place in five more cities - Milan, Turin, Naples, Bologna and Trieste - with other municipalities also voting.

Nearly 9 million people are eligible to vote on Sunday.

Turnout was low at 62.1 per cent in the first round in June, compared to 67.4 per cent in the previous elections, the Interior Ministry said.

If Raggi wins, she will be the youngest mayor in at least a century. Her victory would also save M5S founder, comedian Beppe Grillo from following through with a campaign promise to "set [him]self on fire" in case she did not make it.

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