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A key to species belonging to the genus Diamesa Meigen, 1835 (Diptera, Chironomidae) from the Alps and Apennines (Italy) is presented using characters observable in the fourth-instar larva. The larvae are separated on the basis of qualitative and quantitative characters. At present fifteen species from the Italian Alps are described in all three life stages, but only twelve species groups can be separated as larvae. The separation is based on the length and thickness of anal setae, antennal ratio, head capsule color and few other characters of the labrum and mentum. The shape of mental and mandibular teeth is still a valid taxonomic character, but unfortunately these characters can be rarely used because teeth are often excessively worn in samples collected in the field. Quantitative characters show variability within each species, differing according to the duration of larval development and must be used with caution. The species groups which can be separated in the larval stage are: the dampfi group, which includes D. dampfi and D. permacra, the latitarsis group including D. modesta and D. latitarsis, the zernyi group including D. zernyi and D. vaillanti. The species within each of these groups at present cannot be separated. D. starmachi, D. steinboecki, D. goetghebueri, D. bertrami, D. aberrata, D. incallida, D. cinerella, D. tonsa and D. insignipes can be separated from all the other known species in larval stage. [ABSTRACT FROM AUTHOR]