The Republic sealed a World Cup play-off spot while Italy confirmed their place in South Africa as group winners after a dramatic draw in Dublin.
Stoke City's Glenn Whelan gave the hosts the perfect start with a superb 20-yard strike after eight minutes.
The Italians levelled on 23 minutes through Mauro Camoranesi's header.
Sean St Ledger headed in after 87 minutes to put the Republic back in front but Alberto Gilardino fired home the equaliser in the final minute.
The Republic's bright start was rewarded with Whelan's excellent strike from a perfectly executed free-kick.
Liam Lawrence slipped the ball into the path of his Stoke City team-mate and the unmarked Whelan curled the ball into the top corner from 20 yards.
The hosts pressed for a quick second goal and Aiden McGeady worked himself into a dangerous position, only to loft his cross high and wide.
The Italians began to take control midway through the half with Fabio Grosso a major threat on the left.
Pirlo set up the equaliser with an inswinging corner and Shay Given failed to keep out Camoranesi's powerful near-post header.
Whelan picked up a booking for a foul on Angelo Palombo to leave him suspended for Wednesday's final qualifier against Montenegro.
Nicola Legrottaglie netted for the Italians at the start of the second half but it was ruled offside.
Both sides created half-chances as the game began to open up and Keith Andrews blazed over after Lawrence's free-kick hit the wall.
Republic boss Giovanni Trappatoni made a change in attack with Leon Best coming on for Kevin Doyle
Gianluca Zambrotta fired in a low shot which the alert Given pushed round the post.
St Ledger restored the Republic's lead with a diving header at the far-post from Stephen Hunt's pinpoint free-kick.
But the Italians were not finished and substitute Gilardino slipped the ball past Given from 12 yards with just seconds left.
Republic of Ireland: Given, O'Shea, Dunne, St. Ledger, Kilbane, Lawrence, Andrews, Whelan, McGeady, Keane, Doyle.
Italy: Buffon, Zambrotta, Chiellini, Legrottaglie, Grosso, Camoranesi, Palombo, Pirlo, De Rossi, Iaquinta, Di Natale.
Referee: Terje Hauge (Norway)
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