Playing only her second match since her quarter-final loss in the Australian Open in January because of a persistent foot injury, the fourth-seeded Belarusian showed her usual grit but looked rusty as she was bundled out of the Wimbledon warm-up event on England's south coast.
The twice Australian Open champion had hoped to gain some match practice on grass ahead of next week's Wimbledon with a wildcard entry in Eastbourne but came up against an inspired Giorgi and joined several top seeds to lose early.
Azarenka, whose only other match since the Australian Open was in March at Indian Wells, battled back from 4-2 down to win the first set but quickly tired against her aggressive opponent.
The Italian seized the initiative and the second set, and after winning an epic game to move 6-5 ahead in the third she secured an unforeseen, if not surprising, three-set victory.
Despite defeat Azarenka said the two hours and 47 minutes spent on court had not been in vain.
"That's exactly what I wanted," she told a news conference. "I wanted to have a competitive match, I wanted to test myself and play for a long time and see how my body is going to react.
"It was the most important thing for today that I was there playing and I was healthy and that's great news.
"I can only get better from here."
Azarenka's defeat was among some notable exits in the first round of the women's draw, with another former world No.1 and third seed Jelena Jankovic losing in straight sets to American Madison Keys later in the day, following top seed Agnieszka Radwanska's loss on Monday.
(Writing by Sam Holden; editing by Martyn Herman)
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