Regions are first-level local administrations in Italy. Since 2003, regions have extensively used over-the-counter (OTC) derivatives. Since the use of these derivatives is not clearly regulated, derivatives have been employed to hedge outstanding debt and its costs, but there is evidence that derivatives have also been used to pay current expenses. This study empirically investigates the dynamics the debt of Italian Ordinary Statute Regions and the impact of OTC derivatives during the 2007-2012 period, and the results show that derivatives – as measured by negative market value – have a positive and statistically significant relationship with debt.