The distinctive feature of local authorities is the creation of public value in an economically viable way. The relevance of this function explains the wide and deep reform process launched by the Italian lawmakers in the 1990s and aimed at making local authorities more efficient. Under this reform, suitable performance measurement and management systems assume a central role. Empirical evidence, however, shows that, although local authorities started implementing these systems, shortages, delays, contradictions and even setbacks have then prevailed. The aim of this short monograph is threefold: first, it describes the evolution and the state of the art of the performance measurement and management systems of local authorities; second, it analyzes the critical issues at stake in this field; and third, it suggests some possible improvement solutions.