The US FBI has arrested 20 mafia suspects during raids in the Sicilian capital Palermo, New York and Miami.
Italian police say the raids were the result of a two-year investigation.
The suspects are accused of smuggling drugs, attempted murder and money laundering.
The police also confiscated weapons and documents, including lists of extortion victims.
Fourteen of the arrests took place in Italy, the rest in the United States.
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