The authors analyzed the association between fertility rates and well-being measured at regional level. The very low level of fertility in all European countries represents a challenge for national and local policies. The period average number of children per woman (TFR) is far below the replacement level of the generations (equal to 2.1) and is below the number of children desired on average by individuals. How does the gap between intended and realized fertility relate with other well-being indicators measured at aggregate level in terms of social, economic, environmental conditions? We try to answer this question with reference to Italy in the period 2010-2017 through the analysis of the association between the regional fertility rates and a rich system of regional indicators measuring various aspects of the social, economic and environmental quality (Equitable and Sustainable Well-being or Benessere Equo e Sostenibile - BES, in Italian). The results show that in regions best performing in terms of economic conditions and of the functioning of public services as well as in terms of the quality of educational system and of the environment, fertility is higher than the national average. This happens in the North-Eastern areas of the country, while in the South and in the Islands the overall citizens life quality is at the lowest level and fertility continues to decline. This suggests that there is a need for active policies both at national and local level with the aim of reducing economic disparities between citizens and of improving the quality of the public services, especially those oriented towards the family and children.