Massimo Urbani was born in Rome on May 8, 1957, the eldest of five children of Ugo Urbani and Maria Teresa Tamantini, and grew up in the working-class northwest of the city. His father's record collection got him started: he took up the clarinet at eleven, moved to tenor saxophone and then settled on alto. By fourteen he was sitting in at Roman jam sessions with a command of Charlie Parker's language that startled the musicians around him, and the two players who first put him on a professional stage were alto saxophonist Mario Schiano and bassist Marcello Melis. In 1972 he began attending Giorgio Gaslini's jazz course at Rome's Santa Cecilia conservatory as an outside auditor, alongside Maurizio Giammarco, and was soon working in Gaslini's group.

His recording career began at sixteen. In 1973 he appeared on Schiano's Sud, and in the same year he cut two records with Gaslini, Message for BASF and Favola Pop for Produttori Associati, plus Giancarlo Schiaffini's Jazz a Confronto 5 for the Roman label Horo. In the summer of 1974 he played the second edition of Umbria Jazz; Sonny Stitt, in the audience at St. Andrews in Perugia, congratulated him afterward, an encounter Urbani cited for years as a turning point. That November, still seventeen, he made his own leader debut in Rome for Horo's Jazz a Confronto series with the American bassist Calvin Hill and the Argentine drummer Nestor Astarita, Enrico Rava writing the liner notes. Rava took him to the United States in 1976, where he spent his nights in New York jam sessions; Rava's account of the trip is that Urbani outplayed the local saxophonists who came to hear him.

The stretch between 1977 and 1981 built his reputation. At the Capolinea in Milan in 1977 he met the Bolognese producer Alberto Alberti, who opened doors to the American players then circulating through Italy. Over the following years he shared stages or studios with Chet Baker, Art Farmer, Art Taylor, Lee Konitz, Jack DeJohnette, Steve Grossman, Red Rodney, Lester Bowie, Jackie McLean, Sal Nistico, Donald Byrd, Louis Hayes, Beaver Harris, Tony Scott, Kenny Wheeler, and Steve Lacy. The record that carried his name abroad was 360° Aeutopia, cut at the Barigozzi studio in Milan on June 20, 1979 for Sergio Veschi's Red Records with an all-American rhythm section of Ron Burton, Cameron Brown, and Beaver Harris. Italy's critics voted it record of the year in Musica Jazz's 1980 poll. He followed it in June 1980 with Dedication to A.A. & J.C. / Max's Mood, a title spelling out his two other allegiances beyond Parker, Albert Ayler and John Coltrane, recorded in Bologna with pianist Luigi Bonafede, Furio Di Castri, and drummer Paolo Pellegatti.

From the mid-1980s on his working life split between Veschi's Red Records in Milan and Paolo Piangiarelli's Philology in the Marche, the two labels that between them hold most of what survives of him on tape. Piangiarelli recorded him relentlessly, in clubs and theatres across central Italy, and released the results for decades afterward: the November 24, 1984 concert at the Teatro Comunale in Urbisaglia, a March 1987 duo session with pianist Mike Melillo built entirely around Parker material, and live sets from Chieti, Ancona, Rimini, Turin, Ferrara, and Rome that kept appearing on Philology long after his death. The Red Records side produced Easy to Love, recorded in Rome on January 18, 1987 with pianist Luca Flores, Furio Di Castri, and Roberto Gatto, and his appearance on Giovanni Tommaso's quintet album Via G.T. alongside Danilo Rea and Paolo Fresu. He also turned up on Enrico Pieranunzi's Isis in 1981, on Luca Flores's Where Extremes Meet in 1987, and on Philology's Chet in Italy documenting his encounters with Chet Baker.

His last studio date was The Blessing, made in early 1993 for Red Records with Danilo Rea, Giovanni Tommaso, Roberto Gatto, and his younger brother Maurizio Urbani, a tenor saxophonist, on a session Gatto co-produced. Urbani passed away in Rome on June 24, 1993, at thirty-six, of cardiocirculatory collapse brought on by a heroin overdose; he had been dependent on the drug for much of his adult life, had an autumn tour booked, and was expecting a child. In 1996 Piangiarelli founded the Premio Internazionale Massimo Urbani at Urbisaglia, in the theatre where he had recorded him twelve years earlier. Now run by the Musicamdo association in Camerino, it has become Italy's principal competition for young jazz soloists; among its winners are Francesco Cafiso, Gianluca Petrella, and, in the international category in 2008, the blind Israeli-Italian pianist Yakir Arbib, whose Philology contract followed directly from the prize.

Urbani built his sound out of three sources he never tried to reconcile: Charlie Parker's phrasing, which he had absorbed whole by his mid-teens and could quote at will, and the raw upper-register crying of Albert Ayler and late John Coltrane. What came out was a bebop vocabulary played with a hard, nervous vibrato and a sharply clipped articulation, capable of dropping the changes mid-chorus for a passage of open screaming and then landing back on the form as if nothing had happened. He was a fast, physically forceful improviser who worked best in front of a live audience, which is why so much of his surviving catalog is concert tape rather than studio work, and his readings of standards ("Easy to Love," "Out of Nowhere," "Invitation") tended to leave the melody behind after a single chorus. Enrico Rava, who knew him from his teens, described him as "that eternal sweet boy, unreliable, tender, generous, unbearable and brilliant." Italian critics voted 360° Aeutopia the best record of 1980 in Musica Jazz's annual poll, and Phil Woods, another alto player raised on Parker, wrote the notes for the posthumous Philology anthology Invitation.