Regional elections in Piedmont were ruled by the Tatarella law, which was approved in 1995 and provided for a mixed electoral system. Four fifths of the regional councilors were elected in provincial constituencies by proportional representation, using the largest remainder method with a Droop quota and open lists, while the residual votes and the unassigned seats were grouped into a single regional constituency, where the whole ratios and the highest remainders were divided with the Hare quota among the provincial party lists; one fifth of the council seats instead was reserved for regional lists and assigned with a majoritarian representation system, in which the leader of the regional list that scored the highest number of votes was elected to the presidency of the region, while the other candidates were elected regional councilors.

A threshold of 3% had been established for the provincial lists, which could still have entered the regional council if the regional list to which they were connected had scored at least 5% of valid votes. The panachage was also allowed; the voter can indicate a candidate for the presidency but prefer a provincial list connected to another candidate.

Bresso was one of the last bulwarks of the country's centre-left coalition in Central Italy and thus all Democratic Party members endorsed her in a key test of the coalition's strength after two years in opposition in Rome. For his part, Cota's choice was a little bit surprising as Piedmont is not really a stronghold for his party, which is much stronger in Veneto and Lombardy. The day after his bid was announced, Cota explained that it is time to rewrite the history of Italian unification, that was led by the Kingdom of Sardinia under the House of Savoy. Cota underlined that Piedmont was once an independent state and told that even Camillo Benso, Count of Cavour, did not intend to unify the whole Italian Peninsula and later favoured a federal reform of the new Kingdom of Italy.

Cota, who is a republican and has no nostalgia of the House of Savoy, said his message would do well in Piedmont and that he would overcome the weakness of Lega Piemonte that usually gets far fewer votes than Liga Veneta in Veneto and Lega Lombarda in Lombardy. In Cota's view, most of his support would come from industrial workers, including those of Southern Italy descent, and Catholics embarrassed by Bresso's secularism.^[2] The Union of the Centre, whose main aim in the election was to fight back the Northern League, chose to support Bresso, turning down the chance of running its own candidate, the most likely being Michele Vietti.^[3] Most Catholic voters disagreed.

• 2010 Italian regional elections