The Italian GP featured all the World Championship regulars and a variety of additional entries including a third Ferrari for Ludovico Scarfiotti. Phil Hill had disappeared from the Cooper team and had been replaced by Rhodesian driver John Love who had showed well with Ken Tyrrell (the Cooper team manager) in Formula Junior. Surtees was fastest in practice and lined up on the front row alongside Dan Gurney's Brabham and Graham Hill's BRM. Jim Clark shared the second row with Bruce McLaren's Cooper while the third row featured Jo Siffert in his privately-entered Brabham-BRM, Ferrari's Lorenzo Bandini (the winner of the previous race in Austria) and Mike Spence in the second Lotus.

At the start of the race McLaren took the lead from the second row with Gurney and Surtees chasing but Hill was left on the grid for the second consecutive race, this time with a clutch failure. Monza provided the usual exciting slipstreaming battle and McLaren was quickly pushed back to third behind Gurney and Surtees. The two managed to get slightly ahead and spent most of the afternoon switching places until Gurney dropped back in the closing stages with engine trouble. McLaren and Clark enjoyed a similar battle for third place until lap 27 when Clark retired with an engine failure. The battle for fifth place in the early laps was wild and it continued for most of the afternoon before Jack Brabham finally got ahead of the pack. By then Clark had gone and so Brabham was fourth but he went out on lap 59 with engine failure, leaving Bandini and Ginther to battle for what would be third place all the way to the line. Surtees won by over a minute with McLaren by himself in second while Bandini beat Ginther to the line by the smallest of margins, which was later judged to have been one tenth of a second.

Surtees's victory had put him into contention for the World Championship, four points behind Graham Hill and just two behind Jim Clark.