The court rejected an appeal by the defense and upheld an earlier ruling by the appeals court in Bologna.
Lawyer Nicola Canestrini said on Wednesday he acknowledges the decision and expects his client to be transferred within days, adding he still hopes for an acquittal.
Serhii K., a 49-year-old former soldier, was arrested in August near Rimini while on vacation with his family under a European arrest warrant.
Italian courts in successive instances have backed his transfer so Germany can prosecute him for damaging the pipeline.
Canestrini has argued there were serious procedural violations and that the principle of mutual trust between states was not respected, pointing to an October 17 decision by a Warsaw court refusing to extradite another Ukrainian Nord Stream suspect, Volodymyr Zhuravlov, to Germany.
He also cited concerns over detention conditions and trial guarantees in Germany, as well as the political and military nature of the alleged sabotage, which he says is linked to an international armed conflict and should fall outside the scope of a European arrest warrant.
According to German prosecutors, Serhii K. and his associates allegedly used a yacht hired under false identities from the port of Rostock, with divers attaching at least four explosive charges to the Nord Stream pipeline before being taken back towards Ukraine.
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Source: PAP