During the 2018/19 international season for Italy, they won just one in nine games; defeating Georgia 28–17 during the November test window. They lost all games during the 2019 Six Nations Championship, finishing bottom of the table for the fourth year in a row, three times under O'Shea. At the 2019 Rugby World Cup, Italy were eliminated in the pool stage, finishing in third place in Pool B behind New Zealand and South Africa; although this granted them automatic qualification for the 2023 Rugby World Cup, O'Shea resigned in November 2019, six months before the end of his contract with the Italian Rugby Federation, to take a position as the Rugby Football Union's (England) director of performance.