Four-time world champions Italy failed to qualify for a third World Cup in a row after a penalty shootout defeat by Bosnia-Herzegovina.

No previous winner of the tournament has missed three consecutive instalments of the competition, after they also failed to reach Russia in 2018 and Qatar 2022.

Pio Esposito and Bryan Cristante missed their spot-kicks in the shootout after Gennaro Gattuso's 10 men had held on amid a barrage of Bosnian shots to take the game to penalties.

Bosnia-Herzegovina have qualified for just the second time and will face Canada, Qatar and Switzerland in Group B this summer.

Italy led when Moise Kean provided a fine finish from the edge of the area after Nicolo Barella pounced when Bosnia goalkeeper Nikola Vasilj misplaced a pass in the 15th minute.

But the home side's hopes of a comeback were enhanced when Italy defender Alessandro Bastoni was sent off for hacking down Amar Memic with the Bosnia winger clean through on goal five minutes before the break.

Italy keeper Gianluigi Donnarumma was forced into a string of second-half saves but when he pushed out Edin Dzeko's header from Amar Dedic's 79th-minute cross, Haris Tabakovic managed to turn home the rebound to force extra time.

The hosts were then perfect from the spot with Benjamin Tahirovic, Tabakovic, Kerim Alajbegovic and Esmir Bajraktarevic scoring to secure their place in the summer tournament.