Stage four of Tirreno-Adriatico linked Foligno to Montelupone over 171 hilly kilometres, with Passo del Cornello and three times the arduous climb into Montelupone.

Five riders broke away on Passo del Cornello, they rode most of the stage ahead of the peloton. The gap reached up to 6'30", but is dwindled then progressively until they were reeled in.

The real fight began on the second ascent into Montelupone, leaving a 30-wheel group at the head of the race. The stage was won by Joaquin Rodriguez (Caisse d'Épargne), ahead of Davide Rebbellin (PVC Diquigiovanni) and Thomas Lövkvist (Columbia-Highroad). Robbie finished 183th.

Rodriguez, who was already winner at Montelupone, takes the leader's jersey away from El Fares.

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