Milan's first-leg loss to city rivals Inter Milan leaves hopes of Champions League glory hanging by a thread - and they are yet to secure a return to the competition for next season via Serie A. Meanwhile, their hosts last won in March - against none other than Inter.
Match preview
As if losing to their fiercest foes three times in a season for the first time since 1995 was not bad enough, Milan's defeat in Wednesday's Derby della Madonnina means they are now outsiders to progress from the Champions League semi-finals.
The designated home team at San Siro, the Rossoneri were backed by an overwhelmingly red-and-black crowd, but they merely produced a passive performance similar to several in Serie A of late.
Blown away by Inter's lightning-fast start, Milan found themselves two goals down within 11 minutes and were unable to truly recover, so if they are to reach a first European final since 2007 they have it all to do in next week's return.
Without star man Rafael Leao following his injury in last Saturday's 2-0 win over Lazio - when Ismael Bennacer opened the scoring and Theo Hernandez netted the second with a typically surging sprint from deep and powerful finish - Milan were short of attacking ideas in midweek, but they cannot afford to continue in such a vein at Stadio Picco.
Outside Serie A's top four with just four games to play - trailing behind fourth-placed Inter - Stefano Pioli's side have picked up 23 points in the second part of the 2022-23 campaign, and the last time Milan accrued fewer from the 15 games after a season's halfway point was back in 2017.
They have drawn both of their last two away matches 1-1 before heading to La Spezia, but those results came against mid-table Bologna and European contenders Roma; this week, they will tackle a side scrapping desperately for survival.
Having lost 2-1 to Milan in November's reverse fixture, when Olivier Giroud snatched a late win for the home side at San Siro, Spezia have won just twice across six previous meetings between these clubs in all competitions.
More pertinently, the Aquilotti have not tasted victory in any of their last eight league games ahead of Saturday's fixture - with terrible timing, that matches the club's longest streak without a Serie A success.
As a result, they now occupy 18th place in the table with only four rounds remaining and are three points adrift of Hellas Verona, who they had looked down upon for most of the season.
A 2-0 defeat at fellow strugglers Cremonese last week made the source of their troubles plain for all to see: Spezia have failed to score in 10 of 19 matches so far this year - as many as in all 34 played during 2022.
Top scorer M'Bala Nzola has shouldered a heavy burden for Leonardo Semplici's men over the course of the campaign, but even he is not immune to such a malaise, having failed to find the net in his last three appearances - equalling his worst run of an otherwise productive season.
Spezia Serie A form:
D
L
D
L
L
L
AC Milan Serie A form:
D
D
W
D
D
W
AC Milan form (all competitions):
D
W
D
D
W
L
Team News
In addition to Rafael Leao's ongoing absence, Milan have been dealt a further blow by news that Ismael Bennacer - who was forced off in the first half against Inter - will be out of action for months with a serious knee injury.
Alessandro Florenzi and Zlatan Ibrahimovic remain sidelined too, while Malick Thiaw must serve a suspension for accumulated bookings.
With their semi-final second leg to come on Tuesday, the visitors may resort to some squad rotation at Stadio Picco - a move which has rarely worked out well in recent weeks - so Ante Rebic, Divock Origi and Charles De Ketelaere are all in line for promotion from the bench.
After turning to Uzbek forward Eldor Shomurodov as a stand in for first-choice striker M'Bala Nzola, Spezia can now welcome the latter back from injury to lead their misfiring front line.
However, Emil Holm, Jacopo Sala, Joao Moutinho and Milan loanee Daniel Maldini are still out of action; narrowing the options available to Leonardo Semplici.
In addition, versatile midfielder Kevin Agudelo is suspended, so Daniele Verde may be recalled to the hosts' attack, alongside Nzola and captain Emmanuel Gyasi.
Spezia possible starting lineup:
Dragowski; Amian, Ampadu, Nikolaou, Reca; Esposito, Ekdal, Bourabia; Verde, Nzola, Gyasi
AC Milan possible starting lineup:
Maignan; Calabria, Kalulu, Tomori, Hernandez; Tonali, Krunic; Saelemaekers, De Ketelaere, Rebic; Origi