Scotland and Italy both remain unbeaten in Group C after sharing a thrilling draw at Workington in the World Cup.
Matt Russell and Kane Linnett tries put Scotland 14-0 ahead but Italy's Cameron Ciraldo and Raymond Nasso both scored to make it 14-12 at half-time.
Danny Addy and Ben Hellewell touched down either side of Nasso's second as Scotland extended their lead to 26-18.
Chris Centrone and Anthony Minichiello put Italy ahead before Hellewell's try ensured both sides picked up a point.
The sides have met just once before at full international level, when Scotland ran riot winning 104-0 in Padova in 2009, but this was a much more exciting contest.
With the sun shining over Derwent Park but the rain lashing down, there was an edgy opening to the game and Huddersfield's Super League Man of Steel Danny Brough kicked a penalty as Scotland led 2-0 midway through the first half.
However, Russell, who kicked the winning points in Scotland's 26-24 win over Tonga, showed why Warrington have signed him for the 2014 season, by scoring the first of the game's 10 tries.
The full-back jinked and shimmied past Italian defenders before reaching the try-line and although it looked like he was held up, the score was awarded by video referee Thierry Alibert.
Minutes later, Linnett was quickest to react to Brough's grubber kick and he touched down in the corner to open a healthy advantage for the Bravehearts, who dominated the opening 30 minutes.
However, Italy were back in the game before half time when Ciraldo picked up Ryan Ghietti's kick through to score.
And they reduced the deficit to two at the break as Nasso scooted from dummy-half and burrowed under the defence for his first try.
Scotland immediately extended their lead after the restart when Brough's high kick was collected by Hellewell, who fed Brett Carter and the winger offloaded to Addy who finished a well-worked move.
But again Italy hit back with Nasso grabbing his second in similar style to his first.
The exchange of tries continued as Carter - playing on his home ground - provided an assist for Hellewell, before Centrone dived over in the corner for the Italians and Joshua Mantellato added the conversion. It meant Italy trailed by just two points with the scoreline at 26-24.
Italy took the lead for the first time when Anthony Minichiello swooped to ground the ball, but Hellewell rounded off a sublime team move after ingenious individual play from Brough to make it 30-30 with 10 minutes remaining.
However, the impeccable Brough, who had kicked five goals, was wayward with his conversion attempt.
The draw sets up an interesting final round of games.
Scotland play Group D side United States, who have won both their games so far, in the inter-group match at Salford on Thursday.
On Sunday Italy face Group C rivals Tonga, who also have to play their inter-group match against Cook Islands on Tuesday.
Teams in Groups C and D play an additional inter-group match during the group stage with the top side from each going through to the quarter-final.
The top three teams from Groups A and B also advance to the last eight.
Scotland coach Steve McCormack:
"I've got to a stage now where I do enjoy it, probably a few years ago I wouldn't have done but the older you get and the dafter you get you start enjoying it a bit more
"I enjoy watching a team that gives absolutely everything. As a team, that's twice in four days that we've given absolutely everything.
"If we can mix that with a bit of skill like we've shown, then we've got a chance of getting to the quarter-finals on Thursday without playing exceptionally well.
"We're looking forward to what's going to be a fantastic game, USA have been one of the outstanding teams of the competition so far, so that's looking to be a magnificent game."
Italy coach Carlo Napolitano:
"I think especially after going 14-0 down we had an uphill battle and we showed great character.
"The perfect rugby league game is when you're winning and there are no mistakes but in our game there were a few and we'll have to work on them.
"There are areas that we've already addressed with the boys, but we just showed great character."
"It's not cost us anything apart from a point. Apart from that we were a bit unlucky with a few of the decisions. But this is rugby league,"
Scotland: Russell, Hurst, Hellewell, Linnett, Carter, Brough, Wallace, Walker, I. Henderson, Douglas, Addy, Ferguson, Kavanagh.
Replacements: Fisher, B. Phillips, Stringer, Wilkes.
Italy: A. Minichiello, Mantellato, Tedesco, Guerra, Centrone, Falcone, Ghietti, Laffranchi, Parata, Vaughan, M. Minichiello, Ciraldo, Riethmuller.
Replacements: Snowden, Tramonte, Santi, Nasso.
Referee: Henry Perenara (New Zealand)