The Semovente 75/46 M43 was an Italian self-propelled gun developed jointly by Germany and the Republic of Salò. In February 1943, the 105/25 M43 self-propelled gun was created based on the extended M42 chassis. It was equipped with a 105-mm howitzer and was intended to combat enemy infantry and tanks. Production began in April, but its shortcomings soon became apparent: the gun was too heavy, its penetration was insufficient, and it was difficult to load. To remedy these issues, the decision was made to replace the gun with the German PaK 40. The new vehicles were designated the 75/46 M43, a designation that remained with them throughout production. However, this period was short-lived. Due to the slow production process of licensed PaK 40 copies, only seven vehicles were fully equipped. Other, later modifications were produced with the Italian gun and were designated 75/34 M43. Interestingly, some of these vehicles were evacuated to Germany and participated in the defense of Berlin in 1945, including one that defended the Reichstag.

The 75/46 M43 was introduced in Update 1.85 "Supersonic". It is a decent SPG in some ways comparable in effectiveness to the Jagdpanzer IV. This Italian self-propelled gun has a low profile, a powerful 75mm gun, excellent mobility, and decent frontal armor. These features make it a very dangerous opponent. However, it has several drawbacks: its 6 km/h reverse speed is often insufficient, its roof armor is weak, and its gun has limited elevation and traverse angles. Furthermore, the two 60 mm plates on the front are easily penetrated, and a tightly packed crew with ammunition sits behind them.