STRUGGLE FOR THE MIDDLE SEA is primarily a reference work focusing on surface naval actions in the Med during WW2. It covers the entire war and all the major powers including Britain, France, Germany and the US but best documents those actions which impacted Italy's maritime war (and so the period from 6/40 to 9/43 is of most interest.)
To some extent this work is meant as an antidote for Anglo-centric (and German) accounts of the naval war in the Med which focus on Italy's failure to win, or even participate in, a decisive surface action in the Nelsonian tradition. O'Hara's thesis is that Italy ground out the naval war of attrition that was best suited to its war aims and limited capabilities. In the Central Med the Regia Marina generally succeeded in achieving it's goal of sea control. The author's view is that while the Royal Navy was certainly successful in winning "sea control victories," strategically speaking it simply had its feet set wrong. His key point is summarized on page 259: "With regard to Italy's mercantile war ... 98 percent of the men and 90 percent of the material that set forth from Italian ports for Libya, Tunisia, of the Balkans arrived safely."
Those who enjoy naval games and simulations will find a lot to like here regardless of whether they agree with O'Hara's overall thesis. By his definition Italian warships (from minesweepers on up to battleships,) participated in 34 of the 55 major surface actions fought in the Mediterranean (including the Red Sea,) during the 5 years of WW2. The accounts of all 55 battles includes an order of battle table listing the ships (by type,) formations, and commanders involved. And, as befits a work with a tactical focus, there are lots of maps and tactical illustrations (27 to be exact,) to help place the operations in perspective. Of course the fights sparked off by Allied attempts to run convoys through to Malta are included but, again, O'Hara's framework ALSO shows the many battles that were fought over Italian convoys etc...
This book strikes me as a perfect complement for Greene and Massignani's THE NAVAL WAR IN THE MEDITERRANEAN 1940-1943 or (so I'm told,) De Belot's THE STRUGGLE FOR THE MEDITERRANEAN 1939-1945. The reason I say this is that things like grand strategy, economics, diplomacy, Taranto, special forces and the submarine war are mentioned in perspective but given very little direct focus or analysis in this work. Therefore it shouldn't be your first book on the Med. Overall, however, I think this will be a worthwhile addition to almost anybody's WW2 naval library; most particularly if you are looking for a detailed accounting of tactical surface actions fought by escorts, destroyers and cruisers of the Italian Navy.