At the 29th minute, Tommy Smith was booked for pulling down Daniele De Rossi in the penalty area. Vincenzo Iaquinta stepped up to level the scores for Italy.
The second straight draw for the Azzurri laid bare the lack of talent in the current squad which ignored creative forward Antonio Cassano.
Italy coach Marcello Lippi refused to accept he had left more talented players home.
"I am absolutely convinced there are no phenomenons that I left at home," Lippi said.
"We have players who have personality, players who have proved it in the championship. We have the Serie A top scorer of 29 goals in Antonio Di Natale."
In an earlier Group F game, held in Bloemfontein, Paraguay moved closer to a last 16 spot with a convincing victory over Slovakia.
A beautiful goal by Enrique Vera put the South Americans ahead and Carlos Riveros killed the game with a brilliant late strike.
Slovakia are on the brink of elimination as they end their group action against a hungry Italian side.
For most of the first half, Paraguay attacked at will and their first goal came in the 27th minute when Lucas Barrios split the defence with a superb pass and Enrique Vera struck the ball into the corner of the goal.
Riveros completed Paraguay's tally in the 86th minute, blasting home from the edge of the box.
Paraguay coach Gerardo Martino called his side "deserved winners", saying "we are feeling quite calm but very happy too."
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