At the turn of the 19th and 20th centuries, the Gorizia and Gradisca regions experienced an outbreak of Pellagra. The disease, which spread from Italy, mostly affected the poor rural population of the Friuli plains and was conditioned by a lack of dietary diversity, given that the agriculture of the Gorizia and Gradisca regions primarily focused on the production of maize. In turn, corn became the staple and almost exclusive diet of the poor. A combination of the unvaried diet, adverse health conditions and poor hygiene led to a B3 vitamin deficiency, facilitating the spread of the disease. The ensuing epidemic in the region affected thousands of mostly poor people in the 1880s. The article describes the spread of the disease in the Gorizia and Gradisca regions and the measures taken by the authorities to mitigate its effects and help the population affected.