The draw means Sweden go through 1-0 on aggregate after winning the first-leg by the same scoreline.
Italy's legendary goalkeeper Gianluigi Buffon struggled to fight back tears but remained positive about the future as he tried to come to terms with Italy's failure to qualify for a World Cup for the first time in 60 years.
"The pressure is all on them", said the former Genoa player.
Italy's streak of 14 consecutive World Cup appearances is snapped.
"We must be confident in the return leg, otherwise we have already lost". "We couldn't do it in any other way, they are so skilful".
Italy coach Gian Piero Ventura blamed bad luck and the referee for Friday's defeat in Stockholm.
Neither team was particularly impressive in the first leg of this matchup but Italy had a very disappointing display.
"I leave a squad of talent that will have their say, including Gigio Donnarumma and Mattia Perin".
Despite 64 per cent possession and ten shots on goal in the first leg, Italy failed to score away from home and things didn't improve when they returned to the San Siro.
And elimination would nearly certainly mean goalkeeper Gianluigi Buffon playing his final competitive worldwide.
The 39-year-old Buffon - bidding to reach a record sixth World Cup Finals in Russian Federation - is one of the last survivors of Italy's golden generation of 2006 World Cup winners.
It will played at the San Siro.
However, the latest reports suggest that he is now being courted by two national teams who would largely benefit from his arrival. "The only thing that I would have would be a personal satisfaction, but in the wider scheme of things, I am irrelevant". "There are another 90 minutes and we want to make the most of it".