The Russian third seeds led 5-2 in the decider before Errani and Vinci roared back to clinch their fourth Grand Slam title and retain their world number one ranking.
Victory for Makarova and Vesnina would have lifted them to top spot and when they broke twice to lead 5-2 in the final set, they looked set for the title.
But the Italians stayed strong and won five straight games, clinching victory on their second match point when Vinci fired a forehand return winner down the line.
Image: Roberta Vinci (left) and Sara Errani of Italy with the winners trophy.
Photograph: Michael Dodge/Getty Images
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