The title "Duke of Tuscany" refers to a noble rank historically associated with the region of Tuscany in central Italy. The title was established in the Middle Ages and was held by various noble families, most notably the Medici family, who ruled Tuscany from the 15th to the 18th centuries. The dukedom was significant for its cultural and political influence during the Renaissance. In 1860, the title became part of the Kingdom of Italy when Tuscany was annexed. The last reigning duke was Ferdinand III, who ruled until the unification of Italy. Today, the title is largely ceremonial and is not associated with any governing power.