There is described a machine for unpacking, replacing and repacking items packed in boxes, preferably a package leaflet, comprising feeding means (5,9) for the items packed in closed boxes (3), at least one box opening station (100), at least one picking station (200) for the item (1) to be replaced, at least one inserting station (300) for an item (7) replacing said replaced item (1), at least one closing station (400) for the box (3) containing the replaced item (7).