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In modern usage, when referring to the Mafia, there may be several meanings, including a local area's Italian organized crime element, the Mafia family of a major city, the entire Mafia of the United States, or the original Sicilian Mafia.

Widespread recognition of the word has led to its use in the names of other criminal organizations, such as the Jewish Mafia, Mexican Mafia, or Russian Mafia, (not to be confused with the Irish Mob).

From the 1890s to 1920 in New York City the Five Points Gang, founded by Paul Kelly, were very powerful in the Little Italy of the Lower East Side.

They were often in conflict with the Jewish Eastmans of the same area.

The most important unit of the American Mafia is that of a "family," as the various criminal organizations that make up the Mafia are known.