With just a four-day turnaround, the Springboks opted for changes for their Rugby World Cup clash against Canada.
India claimed a late wicket on day four after Rohit Sharma's 127 left South Africa chasing an unlikely 395 to win in Visakhapatnam.
Ruthless South Africa moved to the top of Pool B by dishing out a seven-try hammering to Italy.
South Africa put 14-man Italy to the sword to put one foot in the quarter-finals, but Rassie Erasmus says there was room for improvement.
South Africa produced a valiant comeback against India on day three of the first Test, thanks to Dean Elgar and Quinton de Kock.
India's spinners followed on from double-centurion Mayank Agarwal's fine work to leave India on top after two days in Visakhapatnam.
South Africa's powerful pack will be expected to lay the foundations when the Springboks face Italy in a crunch World Cup clash.
India dominated a shortened day one of the first Test against South Africa, with Rohit Sharma recording a fine century.
Rishabh Pant has lost his Test place to Wriddhiman Saha, who Virat Kohli expects to prove his worth for India against South Africa.
Rassie Erasmus is focusing on a "major forward battle" against Italy, but South Africa have lost utility back Jesse Kriel to injury.