The sequence-based type 1,4,3,1,1,1 of Legionella pneumophila sg.1 is predominant in the Palermo city environment since several years. In this study, extended sequence-based typing and pulsed field gel electrophoresis were used in a combined approach in the aim to enhance discriminatory power of the molecular typing procedures. However, probably due to a common environmental reservoir and genetic stability, most of the strains circulating in the geographic area under study belong to the same clone and are, consequently, indistinguishable by molecular typing. Investigations of clinical cases and tracing to their environmental source require caution and support from sound epidemiological data., (2009 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd.)