The peloton swarmed the front of the race with 53 kilometers to go as some attacks emerged, but without any major effect in the peloton as the likes of Mavi Garcia and Floortje Mackaij spent energy on unsuccessful moves. After Colle Pinzuto SD Worx put the pressure on Van Vleuten as Lotte Kopecky attacked, however chased back by the Dutch.
At the final sector of the race, within a reduced group Annemiek van Vleuten launched a blistering attack, only to be chased by Kopecky herself, which seemed like the decisive move, similar to van Vleuten's tactics at Omloop Het Nieuwsblad. With no collaboration though, the duo was caught with 8 kilometers to go where
Ashleigh Moolman attacked right away, showing the team's strategy as Demi Vollering also tried, but always with the Movistar Team leader on the wheel.
Eventually, the group grew and no-one could escape the group which went into Via Santa Caterina together. Van Vleuten pushed the pace right from the base and in the steepest ramps it seemed like she was almost able to go solo, but the Belgian champions stuck to her wheel and within the streets of Siena the duo fought hard, Kopecky too the final corner in front and took the win. Teammate Ashleigh Moolman Pasio still went on to finish third, wrapping up a successful day for SD Worx.