First of all, in Italian meatloaf is amusingly called polpettone; literally, big meatball, which, if you think about it, is what it is. Italians do not eat meatloaf as much as Americans, but it is standard fare and part of their cuisine, being included in Artusi's famous 19th century compendium, where he encourages the humble meatloaf to enter his book and take its rightful place. I guess if you were called "big meatball" you'd have some self-esteem issues, too.
Differences in the Italian meatloaf (although there are all sorts of variations, of course). Italians tend not to bake it in an oven dish, but just give it a cylinder shape and put it on a flat cooking surface. Surprisingly (as with the original Artusi recipe), some people make it on the stovetop instead of the oven. Others fry it on the stovetop and then put it in the oven; most nowadays go the oven-only route. Very commonly parsley and especially grated Parmesan are added (I added Parmesan yesterday, would recommend). One or more eggs are always included. Italians tend to put bread soaked in liquid (milk or water, I used milk) instead of breadcrumbs. Needless to say, they don't top it off with ketchup, in fact they usually leave it bare. I don't like this, so I made a glaze of tomato sauce, Worcestershire sauce and honey.
They rarely if ever use beef only, but a mixture of beef, pork and maybe veal (I used all three). They don't use onions and/or garlic as much you'd think, although the Artusi recipe calls for both. Some use lemon zest or juice in the mixture, some white wine (or they baste with wine). Some use nutmeg (I did). Finally, they will often make polpettone ripieno or farcito, or stuffed meatloaf. I've never had this, and I'm not sure I'd like to make it. They stuff with ham, cheese, spinach and other such stuff. In the photo, you see the making of a stuffed meatloaf with ham, cheese and artichokes.