The Serie A clash between Genoa and Siena was held up for 45 minutes on Sunday after home fans threw flares onto the pitch and sat on safety barriers.
Genoa, who are only one place above the relegation zone, were losing 4-0 at the time when eight minutes into the second period referee Paolo Tagliavento halted proceedings.
The scene brought back uncomfortable memories of Italy's Euro 2012 qualifier at home to Serbia in the same Marassi stadium in October 2010 when the game was stopped and eventually called off after Serb fans fired flares and scaled barriers.
Genoa captain Marco Rossi went up to the 'Ultra' fans behind one goal to appeal for calm as many home supporters left the stadium in disgust at their team's performance.
Midfielder Bosko Jankovic, who was sitting in the stands, left the ground after an argument with fans, according to Ansa news agency.
Tagliavento and Siena's players went back into the changing rooms as Genoa players negotiated with the fans.
At one point fans demanded the players remove their shirts, presumably believeing they weren't doing the jersey justice.
Some players did remove their shirts but Giuseppe Sculli was chief among those who refused.
When eventually they climbed down from the barriers and allowed the game to restart, many fans turned their backs to the pitch as protests continued.
The ugly images brought condemnation from throughout the game with Siena coach Giuseppe Sannino left dumbstruck.
"I would have never imagined that something like this could be repeated," he said.
"When we went back out onto the pitch to restart the match I told my players this is no longer football."
Genoa president Enrico Preziosi insisted it was only a handful of fans but said the power they wielded was disturbing.
"I'm sorry that 60 or 100 people can say and do as they want with impunity without us having the ability to control them and send them home," he said.
"It's not possible for them to take control of a stadium like that and start to impose their laws."
Italian Football Federation president Giancarlo Abete was outraged by the scenes.
"This is unacceptable violence, these aren't fans," he said. "There are rules and images and I hope they never get back into the stadium. Sculli did well by not removing his shirt."
The game proceeded without further incident, although Siena seemed almost reluctant to inflame the home fans' feelings any more and even contributed an own goal after the restart.
The game finished 4-1 leaving Genoa just one point above the drop zone.
When the game finished, some players, led by Rossi, performed their own silent protest by leaving their shirts on the pitch.