It's claimed this was the first time the game – invented in 1891 – was played in Italy, with Nomi discovering the sport whilst in the United Kingdom and then translating the rules in Italian.

[4] During the 1974–75 season, Sapori Siena finished fifth in the league thanks to a slow-paced style combined with zone defense as twin towers Carl Johnson and Enrico Bovone dominated the paint.

[4] With coaches like Gianfranco Lombardi, Cesare Pancotto and Valerio Bianchini and players Sandro Dell'Agnello, Sylvester Gray, Gerard King, and Larry Middleton the club had solid results, including two Serie A quarterfinals in 1997–98 and 1999–00 and two participations in the FIBA Korać Cup.

Siena would accomplish that goal, sweeping all of its playoff series 3–0 and claiming their first ever scudetto after toppling Metis Varese, Scavolini Pesaro and Skipper Bologna.

[5] The next two seasons put a brake on that success, with the sole addition of the Italian Supercup amidst two quarterfinal eliminations in the league and one Top 16 appearance in the Euroleague.

Siena native and long serving club member Simone Pianigiani was promoted to the head coach role in 2006 whilst the roster was overhauled.

More importantly, a team led by Rimantas Kaukėnas, Joseph Forte and Terrell McIntyre won 39 of the 44 games they played in the Serie A season (with a 3–0 finals sweep) to earn their second league title.

Montepaschi wasn't as competitive, being eliminated at the Euroleague Top 16 stage whilst in the domestic league they finished the regular season in fifth place with 12 losses.

However the holders rallied in the playoffs, winning two Best-of–7 series in game 7, against EA7 Emporio Armani Milano and Cimberio Varese before toppling Acea Roma 4–1 in the finals to add title number seven to the Cup they had earlier won.

[17] Though its financial problems emerged to the fore, with a relegation all but assured due to massive debts, on the court the holders kept fighting, pushing favourites Milan to seven games in the Serie A finals, though they would go on to concede the title.

Furthermore, an inquest had been started in 2012 after suspected undeclared payments and tax evasion by club officials for over 90 million Euro, including former president Ferdinando Minucci.

In the beginnings of 2019, the team's roster was practically dismantled due to the club's financial troubles making it impossible to pay the league's taxes and the wages.

On the 21st of August 2020, it was announced that Mens Sana Siena would be participating on the Group A of the Serie C silver, a regional league representing the 5th Tier of the Italian Basketball Federation.