The prevalence of celiac disease is still significantly under-estimated world-wide. We compared the Emilia Romagna's with international data. We studied symptomatic patients recorded in reimbursement regional health service program. In year 2008, the patients were 7811. Our investigation did not show age related prevalence, except in the age group 0 to 1 probably due to breastfeeding. The overall prevalence is 1,8 patient/1000 of Emilia Romagna citizens. The prevalence is extremely variable in the different districts from 1:384 Parma's area to 1:909 Piacenza's. Our data confirm the underestimation previously found in other countries. Diagnosis (tests and small bowel histology) are performed, but probably a multidisciplinary effort must be made to promote knowledge and to understand pathogenesis of CD.