newly promoted Serie A club Siena, taking over from departing boss Antonio Conte who was signed by Italian giants Juventus. The aim for the small Tuscan club was to escape relegation in what was going to be Sannino's first experience in charge of a top flight club. In the 2011–12 season, Sannino managed to keep Siena safely out of the relegation zone, and also led the club to the Coppa Italia semifinals, then lost to eventual winners Napoli. On 6 June 2012, Sannino signed a two-year contract as head coach of Palermo, only a few weeks after Siena director of football Giorgio Perinetti made the same move to Sicily. His short-lived experience with the Sicilians ended on 16 September 2012, when club chairman Maurizio Zamparini decided to remove him from first team duties after achieving only one point in the first three Serie A games; he was replaced by Gian Piero Gasperini. He was rehired on 11 March 2013. Despite an impressive string of results with a particularly difficult calendar (including wins against Inter and Roma), however, he failed to keep Palermo in the top flight. He was appointed as Chievo coach on 1 July. However, he was sacked on 11 November. On 18 December 2013, he was confirmed as new head coach of Watford. On 15 March 2014, Sannino led Watford to a club record sixth consecutive home win in all competitions without conceding, with a 3–0 win against Barnsley. Despite winning four of the first five league games of the 2014–15 season, and with Watford second in the table, his future was subject to speculation following rumours of dressing-room unrest and some players disliking his management style. Sannino resigned on 31 August, his last game in charge being their 4–2 home win against Huddersfield Town the day before. Later career On 14 September 2014, Sannino returned into management, taking over as new head coach of Serie B club Catania. His period as Catania boss, however, lasted only three months, as he resigned on 19 December following a string a poor results and strained relationship with the club's board. On 29 September 2015, he was appointed manager of newly promoted Serie A side Carpi. On 3 November, it was announced that he had been relieved of his duties and he was replaced by Fabrizio Castori - the man he had initially replaced - as first team coach He was