Sicilian Mafia boss Matteo Messina Denaro, captured in January after three decades on the run, has died in hospital in central Italy, the local mayor confirmed on Monday.

The 61-year-old had been treated for colon cancer while detained in a high-security jail in L'Aquila, but was moved last month to hospital after his condition deteriorated.

L'Aquila Mayor Pierluigi Biondi confirmed the mobster's death in hospital "following a worsening of his illness" in a statement to the ANSA news agency, which had earlier broken the news.

His death "puts the end to a story of violence and blood", Biondi said, thanking prison and hospital staff for their "professionalism and humanity".

It was "the epilogue of an existence lived without remorse or repentance, a painful chapter of the recent history of our nation".

Messina Denaro was one of the most ruthless bosses in Cosa Nostra, the real-life Sicilian crime syndicate depicted in the Godfather movies.

He was convicted by the courts of involvement in the murder of anti-Mafia judge Giovanni Falcone in 1992 and in deadly bombings in Rome, Florence and Milan in 1993.

One of his six life sentences was also handed down for the kidnapping and subsequent murder of the 12-year-old son of a witness in the Falcone case.

Messina Denaro disappeared in the summer of 1993, and spent the next 30 years on the run as the Italian state cracked down on the Sicilian mob.

But he remained the top name on Italy's most-wanted list and, increasingly became a figure of legend. It was his decision to seek treatment for his cancer that led to his capture. He was arrested on January 16, 2023, as he visited a health clinic in Palermo.

He was jailed in L'Aquila, where he continued treatment in his cell, but was moved to hospital in August, under heavy security.

Since Friday night, he had been reported to have been in an "irreversible coma". Medics had stopped feeding him and he had asked not to be resuscitated, Italian media reports said.

His arrest may have brought some relief for his victims, but the mob boss always maintained his silence. In interviews in custody after being arrested, Messina Denaro even denied he was a member of the Cosa Nostra. (AFP)