The No.1-seeded Errani reeled off the first nine games of the match for a 60 30 lead before finally surrendering a game, but it didn't change the momentum and she quietly beat Julia Cohen, 60 61.
"The match was not easy - every game was a fight," Errani said. "I'm very happy for the victory."
Palermo is one of Errani's most successful tournaments - she is now 22-4 lifetime at the tournament, winning it twice (2008 and 2012) and reaching the quarterfinals or better in her four other tries.
"Palermo is a wonderful tournament," Errani added. "I love the clay court season and I play here with a lot of happiness. I hope to do well this week - I'm very happy with the way I started here today."
The other two first rounds were nothing like Errani's, both of them going the distance, beginning with No.7 seed Sílvia Soler-Espinosa rebounding from a disastrous second set to make it by Mathilde Johansson, 64 16 75. Later, Italian wildcard Corinna Dentoni edged Caroline Garcia, 57 64 64.
Palermo has been a WTA stop since all the way back in 1990, and boasts a very impressive list of former champions, including former World No.1 Dinara Safina and Grand Slam champions Mary Pierce and Anastasia Myskina. Former Top 10 players Irina Spirlea, Barbara Schett, Sandrine Testud, Patty Schnyder and Flavia Pennetta have all lifted the International-level clay court title in the past too.