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ROME (AP) — Italy’s No. 1 fugitive, a Mafia boss convicted of helping to mastermind some of the nation’s most heinous slayings, was arrested Monday when he sought treatment at a private clinic in Sicily after three decades on the run.

Matteo Messina Denaro was tried in absentia and convicted of dozens of murders, including helping to mastermind, along with other Cosa Nostra bosses, a pair of 1992 bombings that killed top anti-Mafia prosecutors — and led the Italian state to stiffen its crackdown on the Sicilian crime syndicate. He faces multiple life sentences that he is expected to serve in a maximum security prison and under the particularly restrictive conditions reserved for top organized crime bosses.

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He went into hiding a year after those bombings while still a young man — but he was still considered one of Cosa Nostra’s top bosses even as a fugitive. Hundreds of police officers were tasked over the years with tracking him, the last of three longtime top-level Mafia bosses who managed to elude capture for decades.

He is now 60, and his health condition helped investigators zero in on him, according to Carabinieri Gen. Pasquale Angelosanto, who heads the police force’s special operations squad.

“It all led to today’s date (when) he would have come for some tests and treatment” at the clinic, the Carabinieri general said.

Authorities did not say what he was being treated for, but he was captured at La Maddalena clinic in Palermo, an upscale medical facility with a reputation for treating cancer patients, and Italian media said he was undergoing treatment for a year.

During an evening news conference, authorities said Messina Denaro’s treatment could continue at a hospital prison ward.

Investigators said he was unarmed and dressed like a typical patient at the clinic, though wearing a watch worth at least 30,000 euros (about $33,000).

“He didn’t resist at all,” Carabinieri Col. Lucio Arcidiacono told reporters.

A pair of Carabinieri officers, each holding an arm, walked Messina Denaro down the front steps of the clinic to a waiting black van in pouring rain. He was dressed in a brown leather jacket trimmed in shearling, a matching white-and-brown skull cap and his trademark tinted glasses. His face looked wan and he stared straight ahead.

Shortly after his arrest, the sun peeked through, and a rainbow could be seen in the sky over the clinic.

When dozens of police officers, wearing ski masks, converged on the clinic, local residents knew something big was about to happen. When Messina Denaro was brought outside, applause rang out on the sidewalks.

Palermo Chief Prosecutor Maurizio De Lucia told reporters that the fugitive had used the pseudonym Andrea Bonafede and had an Italian identity card in that name. He used the alias — the surname roughly means “good faith” in Italian — to book a morning appointment at the clinic.

In addition to convictions for the killings of prosecutors Giovanni Falcone and Paolo Borsellino, he was also found guilty of killing Falcone’s wife and several of their bodyguards as well as the grisly murder of a Mafia turncoat’s young son, who was abducted and strangled before his body was dissolved in a vat of acid.