Although medium-sized towns are key components in the polycentric structuring of regional spaces, their evolutionary pathways are less clear than those of cities. This paper considers a set of four medium-sized towns with provincial capital status located in the southern zone of Lombardy, on the fringes of a densely urbanised area dominated by Milan. The population trajectories of these towns and their agglomerations (firstand second-belt municipalities) are investigated in the decade from 2010 to 2020, with a descriptive analysis. The research resulted in three main findings: 1) even in a challenging economic climate, the population trends of the towns considered were affected by proximity to the vibrant Milan metropolitan area; 2) all the towns have gone down the route of reurbanisation, but the suburbanisation process is still ongoing and very intense, especially for the Italian population; 3) there are gaps between cores and belts in terms of population distribution by age group and land take intensity, resulting in differing drives for population concentration or deconcentration.
Medium-sized towns that are more able to “work together as part of a network” enjoy greater population vitality. Medium-sized towns are not a unitary group: even in an area featuring similar structural characteristics, their evolutionary dynamics differ, calling for place-based policies. A drive for population deconcentration is under way in agglomerations linked to medium-sized towns, powered by certain population groups, which could adversely affect the quest for a sustainable development model.