The Italians, who had secured a spot in next year's finals with two games to spare, took a first-minute lead through midfielder Claudio Marchisio before Branislav Ivanovic levelled midway through the first half.
The match passed off peacefully after Serbia lost the reverse fixture in Genoa by a 3-0 walkover because of crowd trouble.
Italy top the group with 23 points from nine matches, ahead of Estonia who have 16 from 10 after beating Northern Ireland 2-1 in Belfast in their final game.
Third-placed Serbia have 15 from nine and need to beat Slovenia away in their last match on Tuesday to secure a play-off berth, as Estonia have a better head-to-head record against the Serbs.
Serbia left-back Aleksandar Kolarov tested Italy keeper Gianluigi Buffon with a long range effort almost straight after the kick-off, before Marchisio scored at the other end after he was put through by Giuseppe Rossi.
The midfielder took Rossi's pass in his stride and easily rounded Serbia centre-back Slobodan Rajkovic before he steered the ball past keeper Bojan Jorgacevic.
The Italians nearly doubled their lead but Jorgacevic denied Giuseppe Rossi with an excellent save, before the home side regained their composure and started to pile on the pressure.
Having made several marauding runs on either flank, Serbia came close when winger Milos Krasic volleyed wide of the far post before they levelled in the 26th minute.
The Italians failed to clear a corner and the rebound fell kindly for Zoran Tosic, whose fierce volley from the edge of the penalty box was steered in from close range by defender Ivanovic.
FULL STRETCH
Kolarov twice had Buffon at full stretch in the second half and striker Marko Pantelic headed Ivanovic's cross inches over the crossbar as Serbia dominated proceedings after the interval, although Italy enjoyed more possession in the closing stages.
Having realised that the Estonians had turned the match in Belfast on its head, Serbia's coach Vladimir Petrovic threw on three forwards in the last 10 minutes, searching for a win that would have sealed Serbia's play-off berth.
"It's a difficult situation now because we have to win in Slovenia but I am happy with the result against Italy and the commitment the players showed because we played against a very strong team," Petrovic told a news conference.
"I expected more from Krasic and Tosic but the Italians defended very well and it was not easy to respond the way we did after falling behind in the first minute," he said.
Italy coach Cesare Prandelli was happy with his team's performance.
"The players showed a lot of character and we played well on a very difficult pitch, but we know that we have to improve in many departments if we are to be one of the title contenders in next year's finals," he said.
"We are not the best team in the world but we will keep working hard to get better and we have the will-power to achieve these objectives."
‘Scoring in a World Cup is like winning the title – can you imagine millions of people celebrating something you did? It’s insane and made me very proud’: Brazil legend explains how much 2002 goal meant to him
'He already had the ability but didn’t use it because he was afraid to shoot – I said, "You’re a player who has to decide games – you have to take risks, mate"': Liverpool star was forced to become confident by team-mates
