Between 1995 and 1997, in the territories of Southern Italy, there were fifteen murders of elderly women over the age of 70 years old. Initially, however, not all the murders were attributed to a single serial killer. The majority of the victims were stabbed multiple times in the neck, except for three cases in which the cause of death was manual strangulation. There was evidence of sexual assault in only one of the cases. All the victims were discovered in their own apartments, which were located on the ground level, with no signs of forced entry. In most of the cases, the offender stole money and/or jewellery. A multi-disciplinary team reviewed the cases during the investigation and created a profile of the killer. The team determined that the method of operation was completely unusual for the local criminal element. They suggested that the perpetrator could be an immigrant, who committed the murders for sexual motivation and who may have been arrested previously for sex-related incidents. On 15th September 1997, a suspect was arrested. He was identified as Ben Mohamed Ezzedine Sebai, a 35-year-old white male, originally from Tunisia. He was charged and convicted of four of the murders and was given a life sentence. In 2005, Sebai confessed to the murders of four additional elderly women, for which nine other people had already been previously tried and convicted, among them, a man who committed suicide in jail. In 2007, Sebai finally confessed to committing fifteen murders that occurred between 1995 and 1997. Sebai also admitted to experiencing sexual gratification at every homicide scene, even though there was no physical proof at most of the crime scenes. The goal of this article is to illustrate a little-known but noteworthy case concerning a serial sexual killer of elderly women that occurred in Southern Italy, highlighting the method of operation, the victim selection process, and the injuries inflicted. The article will also discuss his motivation, the mental health history of the offender, his clinical diagnosis, and his self-reported childhood abuse.