Often e-Procurement systems are implemented because authorities' guidelines, tools or legal setting mandates them. The growing relevance of e-Procurement systems and tools in public health care organisations (HCOs) has raised much attention in business practice and the academic literature, also related to the improvement of public health care services and community welfare (e.g. Henriksen et al., EU Directives 17-182004). The aim of this paper is to explore organisational requirements that a HCO must meet in order to successfully implement an e-Procurement system, in terms of organisational culture, managerial skills, human resource management and capabilities to manage inter organisational relationships and IT infrastructures. We focused our investigation on the Italian Health Care Sector managed by the public in a complex environment. According to an interpretive approach, we conducted a case study research on 33 Italian public HCOs, both hospitals and local health care services,...