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In prison, Bilancia has often been recognized as a "model prisoner". In 2016, after 5 years of studies, he obtained a diploma in accounting disciplines with a score of 83/100, and he is currently studying tourism disciplines at university. In 2017 he obtained his first temporary permit to leave the prison under armed police escort, in order to visit his parents' grave at Nizza Monferrato's cemetery in Piedmont.

In 2004 Donato Bilancia was interviewed live on Rai 1 during the broadcast on Domenica in, in that year conducted and hosted by Paolo Bonolis. The host received bitter criticism for the interview. In 2015, Rai 3 dedicated an episode to Bilancia, in the television show Stelle Nere ("Black Stars").

Bilancia's criminal life and the events that saw him as a cruel serial killer had a major impact in the media of Italy. His story inspired a television miniseries, called Ultima pallottola ("The last bullet"), directed by Michele Soavi, broadcast for the first time in 2003 on Canale 5, with actors Giulio Scarpati, who plays as the officer during the investigations, and Carlo Cecchi, as the serial killer.

On April 12, 2000, after an 11-month trial, Bilancia was sentenced to 13 terms of life imprisonment plus an additional 20 years imprisonment for the attempted murder of the prostitute who survived. The judge ordered that he never be released.

In March 1998, while receiving oral sex at gunpoint from a prostitute, he shot and killed two night watchmen who interrupted, then shot the prostitute, who survived to help develop a police sketch and later testify against him. He also killed a Nigerian prostitute and a Ukrainian prostitute, and robbed and assaulted an Italian prostitute without killing her. On April 12, 1998 he boarded the train from Genoa to Venice because he "wanted to kill a woman". Spotting a young woman travelling alone, he followed her to the toilet, unlocked the door with a skeleton key, shot her in the head and stole her train ticket. Six days later, he boarded the train to San Remo and followed another young woman to the toilet. He used his key to enter, then used her jacket as a silencer and shot her behind the ear. Excited by her black underwear, he masturbated and used her clothes to clean up. The murders of two "respectable" women sparked a public outcry and the creation of a police task force.

Based on the description of the black Mercedes one of his prostitute victims was seen entering the night she was killed, police considered Bilancia "suspect number one" and followed him for ten days. They collected his DNA from cigarette butts and a coffee cup, matching it to DNA found at crime scenes. On May 6, 1998 he was arrested at his home in Genoa and his revolver seized. After eight days in police custody he confessed, speaking for two days and drawing 17 diagrams.

Bilancia was a compulsive gambler who lived alone. His first murder was the October 1997 strangulation of a friend who betrayed him by luring him into a rigged card game, in which he lost £185,000 (about $267.00). The authorities originally thought this death was a heart attack. Bilancia's next two murders were the revenge shooting of the game's operator, and of his wife. He emptied their safe afterward. Bilancia later said these first killings gave him a taste for murder. In all his killings he used or carried a .38 caliber revolver loaded with wad cutter ammunition. He made no attempt to conceal his victims' bodies. That same month, he followed a jeweller home to rob him, then shot him and his wife dead when the wife began screaming. He emptied their safe of jewelry. He next robbed and murdered a money changer. Two months later, he killed a night watchman making his rounds, simply because he did not like night watchmen. He killed an Albanian prostitute and a Russian prostitute. A second money changer was killed next, shot multiple times and his safe emptied.

While still underage, he was arrested and released for stealing a motor scooter and for stealing a truck loaded with Christmas sweets. In 1974 he was stopped and jailed for having an illegal gun. At some point he was committed to the psychiatric division of the Genoa General Hospital, but escaped. After he was apprehended, he spent 18 months in prison for robbery. He served several prison terms in Italy and France for robbery and armed robbery. In spite of his history of psychiatric problems, up to age 47 he had no record of violence.

Donato "Walter" Bilancia, (born July 10, 1951) is an Italian serial killer who murdered seventeen people – nine women and eight men – on the Italian Riviera in the period from October 1997 to May 1998.

Bilancia was born in Potenza, Basilicata, in 1951. When he was about five years old, his family moved to northern Italy, first to Piedmont and then to Genoa in the Liguria region. He was a chronic bedwetter until age 10 or 12, and his mother shamed him by placing his wet mattress on the balcony where it could be seen by the neighbors. When undressing him for bed, his aunt would shame him by pulling down his underwear in front of his cousins to show his underdeveloped penis. At age 14, he decided to start calling himself Walter. He dropped out of high school and worked at jobs such as mechanic, bartender, baker and delivery boy.