The authorities said bystanders outside the clinic applauded the police officers, their faces obscured by balaclavas, who escorted him into a black van that pulled away to a secret location. As the car left, officers hugged each other and raised their fingers in victory signs.
Mr. Guido, the prosecutor, added that like any Italian citizen Mr. Messina Denaro had a right to health care, but would now get his “in a prison.”
That is where Mr. Messina Denaro’s former bosses ended up and died.
Salvatore Riina, the “boss of bosses” responsible for a series of brutal killings of Italian prosecutors and police officers in the 1990s, was captured in 1993, also in Palermo. He had brought up Mr. Messina Denaro as a young killer with a talent for infiltrating local business and politics. Mr. Riina spent the rest of his life in prison, dying in 2017.
Bernardo Provenzano, like Mr. Riina a member of the Corleone family, pulled back from Mr. Riina’s war against the state and the killings of top investigators and journalists. He was arrested in 2006, after 13 quieter years of criminal activities.
Salvatore Lo Piccolo, a possible successor, was arrested a year later.
Only Mr. Messina Denaro remained at large. He disappeared from public life at the age of 31. His father, also a mobster, died in hiding in 1998.
Known as a ruthless boss with a taste for designer clothes and a playboy lifestyle, Mr. Messina Denaro communicated with associates through letters and handwritten messages that he avoided drafting personally. Most of his closest relatives have been arrested over the years for mafia-related crimes, but they never betrayed him. But in recent years, police arrested associates and seized hundreds of millions in assets, depleting his capital.
In 2020, he was sentenced to a life term in absentia for his role in the 1992 murders of the two anti-mafia prosecutors, Giovanni Falcone and Paolo Borsellino, and the bombings in 1993 in Florence, Milan and Rome that left 10 people dead.