Elvira began studying literature as part of her traditional, upper-class education; one of her major inspirations was realist writer Giovanni Verga.

[1] Between 1890 and 1891 Elvira wrote several articles for the Florence-base magazine Cornelia under two pseudonyms, Lucia Vermanos and Ruggero Torres.

[1][2] Mancuso continued to write after Annuzza, producing several essays related to gender inequality in Italian society.

Much of this later criticism was also personally inflected, as it concerned the forced domesticity and rigid lifestyle upper class Sicilian woman were coerced to practice.

Notably, Sicilian playwright and politician Leonardo Sciascia wrote in a preface to the 1981 reprint of Annuzza la maestrina that "There are many truths in this book that do not age".