Economic and environmental efficiency has being receiving growing attention among researchers. In general terms, this concept is related to the capability of the economic systems to employ natural resources efficiently, so as to increase economic and human wealth. This clearly implies that both the economic and ecological aspects of decisions ought to be considered. Bearing this in mind, this paper considers economic and ecological performance together, by applying data envelopment analysis (DEA) and the Malmquist productivity index (MPI) to investigating the efficiency of the 20 Italian regions from 2004 to 2011. The results reveal that the northern regions have been more efficient than the southern ones, highlighting the strong geographical differences between the two. Furthemore this paper uses the Grey System Theory to forecast regional economic and environmental efficiency. The results of the forecasting analysis show that the North-south duality remains strong and will possibly increase since the regions in the south get worse in term of environmental and economic efficiency.