In the literature, the effect of the type of casing on fermented sausages is quite unexplored, while several studies are focused on the impact of starter cultures. Therefore, this paper studied the effect of three commercial starter cultures and two casings (natural or collagen) on Italian fermented sausages. Physico-chemical parameters (aw, pH, weight loss), microbiota, aroma profile and sensory analysis were evaluated. Results showed that collagen casings promoted a higher reduction of pH and weight loss. Concerning the microbiota, samples with natural casing had higher counts of lactic acid bacteria, while yeast proliferation was promoted in those with collagen. Regardless of the starters and casings applied, levels of enterococci and Enterobacteriaceae were low (≤2 log CFU/g). The aroma profile was significantly affected by casing: despite the starter applied, the presence of collagen casing favoured acid accumulation (mainly acetate and butanoate) and reduction of ketones. Sensory analysis highlighted significant differences only for odour, colour intensity and sourness. The differences observed suggest that collagen casings may provide a greater availability of oxygen. Overall, casings rather than starter cultures impact the microbial and sensorial features of fermented sausages.