Thousands were left homeless by three major quakes earlier this year, many are still living in 'containers' or prefabricated homes after months spent sleeping in tents or cars.
But they are determined to stay.
"People in San Pellegrino are strong, brave and resilient," says Denise Abel, a British woman who has been living in the quake-hit town for four years with her husband.
"There's a strong sense of community, and many refused to leave, needing to be with their animals and land."
"Christmas this year will be very different for us," Abel tells The Local. "Usually our house is full of family who travel to us from Milan and from the UK. They will not be with us this year and we'll miss them, but we have good friends in San Pellegrino."
Denise Abel's home before the earthquake. Photo: Private
In Italy, Christmas retains traditional roots, with family and religion often at the heart of the celebrations.
As well as destroying and damaging many homes, the earthquakes left many of the region's medieval churches unusable. One of the most significant cultural casualties was Norcia's Basilica di San Benedetto. Rubble and the crucifix from that church are on display in Rome's St Peter's Square over Christmas.
And in the affected towns, there has been a push to get things back to normal in time for the festive season.
"Norcia made a determined effort to reopen at least the Main Street before Christmas, with a ceremony to switch on some Christmas lights," said Abel.
Amatrice. The Christmas tree has been lit up. This is how life returns, the future is under construction.
Denise Abel's home after the tremors. Photo:Private
In Amatrice, the town which suffered the brunt of the casualties in August's quake, communal dinners will be held in the canteens which have been set up, with a celebration on Friday night, complete with Christmas music and decorations.
Just a week ago, a skydiving Santa descended on the town to distribute gifts and sweets among local children, an event which mayor Sergio Pirozzi said helped "normality return", while admitting that Christmas would not be easy. He has asked each resident to bring a flower to the town's memorial on Christmas Day in order to remember the 299 quake victims.
Many of the towns are hosting Christmas markets to promote local produce, and all in all, over 150 initiatives have been set up to help residents over Christmas, both in the affected Le Marche region and the coastal cities where many displaced residents are staying.
Regional president Luca Ceriscioli said he was convinced that "no-one will be alone" this Christmas. "It's necessary to have a sense of community, and this message has been heard loud and clear, he said."
Judith Mathias, another British expat who bought her home in San Ginesio 11 years ago, has been able to return to her home after spending several weeks in a hostel. She told The Local she had put up Christmas lights and decorated the living room, from where she will be speaking with family and friends at home over Skype.
"We want them to know we are OK this Christmas."
"I've also made Christmas puddings to have along with delicious Italian seasonal delights and several bottles of Prosecco," she added. "And there are lights up in the town too - San Ginesio is open for business!"
A woman sells panettone, Italian Christmas cake. Photo: Judith Mathias
Mathias said she has been impressed by the tireless work of firefighters and rescue workers, and by the resilience and warmth of the locals.
She recalls the fear after the first tremors: "Our house was originally a holiday home, and in July this year we moved here permanently with our lurcher dog, Shaun. It was such a beautiful place - then the earthquakes struck.
"After several nights sleeping in our car in our clothes, our house was deemed safe and we were settling back in and relaxing again when in October the tremors started again. Our house shook violently from side to side, at first we were unable to move, but we managed to get out with Shaun and an emergency bag we had kept by the door."
As for what 2017 will hold, it's far from certain how long it will take to rebuild homes and get the local economy back to how it was. But both Abel and Mathias are determined to stay.
"We have been warmly welcomed by the Italians - who always want to stop and talk about our dog! - and the firefighters, volunteers and rescue workers from all over Italy have been amazing," said Mathias.
Abel agrees. "This year has been a very difficult year for us, with Brexit worries as well as the earthquakes, but the firefighters and civil protection department have been real stars.
"We are determined to have a good Christmas, and that next year we will carry on with our life here."
In San Ginesio, local shops are open for business. Photo: Judith Mathias
If you want to support the residents of towns affected by the earthquakes, the Valnerina Online website offers a good list of places where you can buy food from the area, in order to support local farmers and artisans.