Last week's defeat to Ireland means the Scots' title hopes are over for another year.
Here the PA news agency takes a look at the main talking points ahead of Saturday's Murrayfield showdown.
Hogg aims to be perfect 10
With Finn Russell ruled out due to a concussion, skipper Stuart Hogg will find himself in the saddle on Saturday after being tasked by Gregor Townsend with spearheading Scotland's cavalry charge from stand-off. It's a job he has done on occasion within games for his country but this will be the first time he will walk out with the number 10 jersey on his back. As one of the world's most dangerous full-backs, Hogg is at his most threatening with clear ground to face into. But shunted forward, those wide expanses will be in short supply so this will be a test of his composure and ability to set Scotland's tempo.
One step forward, two back
Scotland felt they were on the verge of something special with last month's historic Twickenham triumph – their first in London since 1983. But they failed to build on that and have now suffered two narrow home defeats against distinctly beatable Wales and Ireland sides. That has been the story of Townsend's reign – flashes of brilliance followed by lulls of frustration. The head coach could do with his team finding some consistent form – and finding it quick – before his performance comes under greater scrutiny.
Scotland's win over the Auld Enemy was built on foundations of a solid set-piece – but against Ireland they crumbled as the Dark Blues won just two of their eight line-outs. Jonny Gray, normally a set-piece totem for the Scots, found himself completely outmatched as James Ryan plucked George Turner's throws for fun. Both Gray and regular sidekick Scott Cummings are injured, with Grant Gilchrist and Sam Skinner coming in to face the Italians. Hooker Dave Cherry has been given his chance to impress on his first start and Townsend will have to hope they can restore Scotland's stable base.
Azzurri struggle again
Italy have long been the whipping boys of the championship but so far this year they have barely managed to even raise a hand in defiance. On average, they have shipped 46 points per game having seen their line breached 26 times in just four matches. Those numbers will do nothing to quell the cry for promotion and relegation to be introduced. But they also leave Scotland stuck between a rock and a hard place. Squeeze to victory – or heaven forbid fail to win – and Townsend's critics will have more ammunition. Win by a landslide and the cynics will say that should be the case anyway.