Due to the novel coronavirus strict rules at the event, in which competitive rounds began Monday, included no showers on site and no autographs or photos with fans.
Players in the singles main draw come from 16 European countries and Argentina.
Tour-level tennis has resumed after a five-month enforced break, with players at the Palermo Ladies Open handling their own towels and not shaking the hands of opponents.
A limited number of fans were allowed into the 1,500-seat stadium court and had to follow social distancing measures.
They watched sixth-seeded Donna Vekić of Croatia beat Arantxa Rus of the Netherlands 6-1, 6-2 in windy conditions in the first official match — for men or women — since early March.
"I’m definitely happy I didn’t forget how to play tennis, how to play matches, how to win,” Vekić said in a video conference. "It’s a huge relief so I’m really happy right now.
Players and anyone who comes into contact with players are being tested for COVID-19 before they depart for Palermo, upon arrival and then again every four days.