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For the third year running, Matteo Berrettini will miss his hometown tournament—this time as the result of an illness that also kept him out of the Mutua Madrid Open.

On Wednesday, the Rome native withdrew from the Internazionali BNL d'Italia. Berrettini, who was scheduled to face countryman Stefano Napolitano Thursday, explained that he needed to take a head-over-heart approach with his decision to forgo competing.

“I'm not ready to perform and to give my best on court. I tried everything because this tournament is extra special for me,” Berrettini said in a statement to press.

“I have to put away my heart, I would say, use my brain a little bit more. Think about what's most important for me, which is my health and not getting injured again, not being away from the courts for months potentially.”

Berrettini is currently ranked No. 95.

Berrettini is currently ranked No. 95.

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Berrettini was sidelined from last September until early-March with an ankle injury he suffered during the second round of the US Open. Upon returning to action, the former Wimbledon finalist finished runner-up at the Phoenix Challenger.

Less than a month later, Berrettini triumphed in Marrakech for his eighth ATP title and first since June 2022. He then bowed out in decisive fashion to Miomir Kecmanovic after making the quick turnaround at the Rolex Monte Carlo Masters and hasn’t played since.

“It's with a lot of sadness that I have to pull out. Just think about this tournament for 2025 and hopefully nothing is going to happen. Maybe wish that's something is going to happen so nothing is going to happen,” he said.

The 28-year-old’s next scheduled appearance is Roland Garros. Berrettini had attempted entry at both Geneva and Lyon, but his protected ranking was not high enough to get into either ATP 250 event that leads into the season’s second major. Depending on player withdrawals or wild cards, that could change.

Napolitano was due to face lucky loser J.J. Wolf.