The 1978 Italian Grand Prix was the 14th motor race of the 1978 Formula One season. It was held on 10 September 1978 at Monza. It was marred by the death of Ronnie Peterson following an accident at the start of the race. The race was won by Niki Lauda (Brabham-Alfa Romeo), after both Mario Andretti (Lotus-Ford) and Gilles Villeneuve (Ferrari), who had finished first and second, were given a one-minute penalty and dropped to sixth and seventh. Lauda's teammate John Watson (Brabham-Alfa Romeo) and Carlos Reutemann (Ferrari) completed the podium.

With three races remaining, Andretti led the World Drivers' Championship by 12 points from Peterson, who was his teammate. Lauda, in third place, was 28 points behind Andretti; with only 9 points for a win, he could not overtake him. Lotus also led Brabham by 33 points in the Constructors' standings. Andretti initially appealed to the penalty but, upon hearing the news of Peterson's death and having become World Champion, he dropped it. Lauda himself gave the Grand Prix trophy to Andretti. As of , this marks the last race win for an Alfa Romeo-powered car. Andretti remains the last American and the second ever to win the Formula One World Championship; these also remain the final Drivers' (6) and Constructors' (7) titles won by Lotus.

Qualifying Andretti took pole position alongside Gilles Villeneuve on the front row (Ferrari), with Jean-Pierre Jabouille (Renault) in third place, Lauda in fourth, and Peterson in fifth.

Pre-qualifying classification DriverConstructorTime1Héctor RebaqueLotus-Ford1:39.882Nelson PiquetMcLaren-Ford1:40.113Brett LungerMcLaren-Ford1:40.24 4Harald ErtlEnsign-Ford1:40.27 5Keke RosbergWolf-Ford1:40.75 6Rolf StommelenArrows-Ford1:40.93 7Alberto ColomboMerzario-Ford1:42.55

Qualifying classification DriverConstructorTime1Mario AndrettiLotus-Ford1:37.52012Gilles VilleneuveFerrari1:37.86623Jean-Pierre JabouilleRenault1:37.93034Niki LaudaBrabham-Alfa Romeo1:38.21545Ronnie PetersonLotus-Ford1:38.25656Alan JonesWilliams-Ford1:38.27167John WatsonBrabham-Alfa Romeo1:38.61078Jacques LaffiteLigier-Matra1:38.91789Jody ScheckterWolf-Ford1:38.937910James HuntMcLaren-Ford1:38.9381011Carlos ReutemannFerrari1:38.9591112Riccardo PatreseArrows-Ford1:39.1791213Emerson FittipaldiFittipaldi-Ford1:39.4211314Didier PironiTyrrell-Ford1:39.5311415Clay RegazzoniShadow-Ford1:39.6211516Patrick DepaillerTyrrell-Ford1:39.6301617Hans-Joachim StuckShadow-Ford1:39.7011718Derek DalyEnsign-Ford1:40.0751819Patrick TambayMcLaren-Ford1:40.1631920Bruno GiacomelliMcLaren-Ford1:40.1992021Brett LungerMcLaren-Ford1:40.3022122Arturo MerzarioMerzario-Ford1:40.7022223Vittorio BrambillaSurtees-Ford1:40.8052324Nelson PiquetMcLaren-Ford1:40.84624 25Héctor RebaqueLotus-Ford1:41.063 26Harald ErtlATS-Ford1:41.185 27Michael BleekemolenATS-Ford1:41.408 28GimaxSurtees-Ford1:41.677

Race First start and Ronnie Peterson accident

During the morning warmup, Ronnie Peterson had a rear brake failure, crashing his Lotus 79/3 at the Della Roggia chicane, reverting to his backup Lotus 78 for the race, which ended up as part of the controversy for the race.

The race started at 15:30 Central European Time (UTC+1). On the warm up lap, Patrick Tambay went into the pits to have his gear-change mechanism looked at. The starter Gianni Restelli was overenthusiastic turning on the green lights before all the cars had lined up, which resulted in several cars in the middle of the field getting a jump on those at the front. The result was a funneling effect of the cars approaching the chicane, and the cars were tightly bunched together with little room for maneuver. James Hunt was overtaken on the right-hand side by Riccardo Patrese, and Hunt instinctively veered left and hit the rear right wheel of Peterson's car, with Vittorio Brambilla, Hans-Joachim Stuck, Patrick Depailler, Didier Pironi, Derek Daly, Clay Regazzoni, and Brett Lunger all involved in the ensuing melee. Peterson's Lotus went into the barriers hard on the right-hand side and caught fire. He was trapped but Hunt, Regazzoni, and Depailler managed to free him from the wreck before he received more than minor burns. He was dragged free and laid in the middle of the track fully conscious but with severe leg injuries. It took twenty minutes before medical help was dispatched to the scene. Brambilla had been hit on the head by a flying wheel and rendered unconscious which resulted in a skull fracture. He was freed from his car by firefighters. Both Brambilla and Peterson were taken to the Niguarda hospital in nearby Milan via ambulance.

Delayed restart

Drivers were allowed to use spare cars for the race restart. Non-starters included Peterson and Brambilla who were taken to Niguarda hospital, Stuck who was not allowed to restart due to him suffering from slight concussion after being struck on the head by a flying wheel in the startline crash, Pironi (as the Tyrrell team had one spare car and that was set up for Depailler), and Lunger who had no spare car available. During the red flag, three time world champion and ABC Sports commentator Jackie Stewart interviewed Andretti and he said "Yeah, it couldn't be worse. Seems like the width of the straightaway invites a lot of passing and dodging it going right into like a funnel and I'm really worried about Ronnie. Yeah, it hit the guardrail at such impact it just incredible, tore everything out and it's very bad". The race was due to be ready for a restart at 17:15. While driving from the pit lane to the grid, Jody Scheckter's Wolf lost a wheel and crashed at the second Lesmo curve, bending the Armco barrier that was situated right next to the track. Scheckter was unhurt and got an ambulance to return him to the pits so he could take the spare car for the restart. Some of the drivers had seen the accident, got out of their cars, and rushed across to race control to get the second start delayed as the Armco barriers were leaning over perilously where Scheckter struck it. Andretti, Hunt, Lauda, Reutemann, and Emerson Fittipaldi all went to the spot where Scheckter crashed. Upon inspection of the state of the barrier, they refused to start until the barrier was repaired, causing more delay. Very little information was forthcoming and the crowds began to whistle and shout, not knowing why there was another hold-up. The barrier was later repaired and ready for the restart.

Second start and race recap Because of the amount of time clearing up the track after the shunt in the first start and the barrier being repaired, plus Scheckter's crash prior to the second start, at 17:50 it was announced that the race would take place and the distance would be shortened from 52 laps to 40 laps to avoid sunset which was at 19:44. The race was restarted at 18:15. Prior to the restart, Jackie Stewart interviewed Andretti and he said "it's no time to feel like celebrating, it just lost its impact, there's no question about it for me. At least for now and I just it's useless to say this is at least really what I expected to happen this particular season. Everything was going so well and well not just for me, both of us Ronnie and I regardless of controversy they were trying, people were trying to build around us, I think both of us felt we had probably the best season ever". Villeneuve overtook Andretti at the restart and at the end of the lap both drivers were side by side; Villeneuve held on to the lead and they pulled away from Jabouille, who was running third with Lauda behind him. After four laps, Regazzoni in the spare Shadow went to the pit lane as he was having his brakes looked at. Jabouille had engine problems after six laps and Lauda took on the pursuit; meanwhile, race control gave Villeneuve and Andretti a one-minute penalty as they were judged to have jumped the start. Andretti took Villeneuve with only five laps remaining. With Jabouille having retired, Lauda finished third ahead of Watson (Brabham), Reutemann (Ferrari), Jacques Laffite (Ligier-Matra), and Patrick Tambay (McLaren-Ford). Since all of those finished less than a minute behind, Andretti and Villeneuve were dropped to sixth and seventh place. Andretti had won the championship but celebrations were muted due to Peterson in hospital. The race was also notable for the first finish for Nelson Piquet with a creditable ninth after dodging the Peterson wreckage in the first start.

After the race, Lotus and Ferrari lodged protests against the one-minute penalty imposed on Andretti and Villeneuve. These protests were rejected.

Death of Ronnie Peterson Peterson was admitted to the Niguarda hospital following his first-lap crash. At the hospital, Peterson's X-rays showed he had 27 fractures in both legs, according to the newly appointed Formula One doctor Sid Watkins in his 1996 autobiography Life at the Limit. It was decided that Peterson was sent to intensive care so that the surgeons could operate to stabilise the bones. Peterson's parents, May Britt and Bengt Peterson, were watching live on TV and knew he was involved in the lap-one incident. They were contacted in their home in Örebro, Sweden by Peterson's manager, Staffan Svenby, who was in Monza. Ronnie's wife Barbro was in Monaco; she was contacted by Team Lotus boss Colin Chapman an hour after the crash.

Once Peterson arrived at Niguarda hospital, Svenby was consulted by the doctors on how Peterson should be operated on and phoned Watkins, three Swedish doctors and other Italian doctors for advice. Disputes were raised regarding Peterson's treatment; the doctors would present him with three options. Peterson could either stay at the hospital in Milan or fly to another hospital where they had experience treating complicated fractures from alpine skiing accidents in countries like Austria, Switzerland, Sweden or England, wait for an operation, risking a worse result and potentially amputation, or operate on the bones at once and risk bone marrow embolism. Svenby decided Peterson would stay in the Niguarda hospital for operation, which was completed without any issue. Over the phone, professor Watkins reassured Barbro that he thought that Peterson would recover, with plans being made for her to get to Milan in the morning. By midnight the following day, Chapman and Andretti returned to their hotel in Como, while Svenby and Watkins booked a hotel near the hospital as they had already checked out from their regular hotels the morning prior.

By 04:00, Peterson, who was now unconscious, had developed breathing problems and was being ventilated by a machine in an attempt to keep his blood oxygen levels normal. An X-ray showed that he had developed multiple emboli in his lungs, which had come from the fat in the bone marrow entering his bloodstream; due to this, his kidneys had started to fail. A neurological examination showed signs of serious brain damage. Professor Watkins, inspecting Peterson's eyes, identified fat globules obstructing the small arteries in the retinas. On Watkins' suggestion, the neurosurgeon agreed to take an electroencephalogram to get the situation clear on Peterson's brain functions. However, by this point, Peterson had suffered a full kidney failure. Peterson was declared dead at 09:55.

Post-race reactions