Autism spectrum disorder (ASD) is a complex neurodevelopmental syndrome of emerging public health concern, according to a documented significant increase of diagnosed cases of ASD in Europe and USA. In Italy, actually, it is not possible to estimate at national level a reliable ASD occurrence by using existing health and scholastic data flows. The lack of information has implications on social and healthcare services dedicated to subjects affected by ADS. The database of the Italian institute in charge of social and security assistance was accessed at the provincial level to investigate the ASD cases occurred in the Palermo province. The official reports of all subjects visited in 2013 by INPS physicians were analyzed by using an automatic software and diagnosis consistent with ASD were extracted and flagged. Our findings support the choice of alternative use of INPS administrative database in order to define a reliable ASD occurrence estimate as first step to develop an integrated epidemiological surveillance system on ASD.