Meanwhile, Chumisa Qawe and Eloise Webb will make their first appearances at the World Cup.
Roos, who scored South Africa's first try in their opening fixture against Brazil, played at scrumhalf in that match, but Springbok Women head coach Swys de Bruin has decided to tweak the backline for this crucial match, with Tose slotting in behind the scrum and Byrhandré Dolf, who started at fullback, moving to right wing in place of Maceala Samboya.
Qawe will start at inside centre in place of Aphiwe Ngwevu, who moves to the bench, where she will be joined by Border Ladies teammate Webb, who replaces Jakkie Cilliers amongst the replacements.
The same pack that dominated Brazil will start against Italy and the same group of forwards that came off the bench in Northampton will do so again.
De Bruin said the tweaks were made specifically with their opponents in mind.
"We have looked at the way they play and decided on this squad for this important match," said De Bruin.
"They don't like to play too much rugby in their own half, often opting to kick for territory, and that is where Nadine's ability on the counterattack will be crucial, and if you add the abilities of Byrhandre in open play, I think we will be effective in combating that."
They are not moving away from their traditional strengths, De Bruin said, just tweaking their approach against the eighth-ranked team in the world.
"We played as recently as last year's WXV 2 in Cape Town and that day we just came up short, mainly due to our inability to combat their kicking game, hence the tactical tweaks," said De Bruin.
"Our pack will still go out to do physical damage and as they showed against Brazil, we are effective in set-piece play."
For the SA coach, the reality of a victory is a huge motivating factor: "A win will almost certainly put us into the playoffs and that was what we came here for. But that is not our focus here in York. We will have to be at our very best to beat Italy, but that was exactly what the hard work leading into this match was all about."
Nolusindiso Booi, who will again lead the Springbok Women this weekend, said their mindset has never been better and they are ready for their date with destiny.
"We know exactly what this result will mean for us as a squad, not only in this tournament, but in the wider sense," said Booi.
"A win will take us into the top ten on the world rankings for the first time and even better, will push us towards that playoff spot that we worked so hard for. This is really it for us and we are ready."
Booi will be one of several players to extend personal records in the match, but said that is not important on a personal level: "It rather shows the growth of this group and how far we have come. And we are not planning at stopping here."
South Africa - 15 Nadine Roos, 14 Byrhandre Dolf, 13 Zintle Mpupha, 12 Chumisa Qawe, 11 Ayanda Malinga, 10 Libbie Janse van Rensburg, 9 Unam Tose, 8 Aseza Hele, 7 Sinazo Mcatshulwa, 6 Sizophila Solontsi, 5 Danelle Lochner, 4 Nolusindiso Booi (c), 3 Babalwa Latsha, 2 Lindelwa Gwala, 1 Sanelisiwe Charlie
Replacements: 16 Micke Gunter, 17 Yonela Ngxingolo, 18 Nombuyekezo Mdliki, 19 Vainah Ubisi, 20 Lerato Makua, 21 Catha Jacobs, 22 Eloise Webb, 23 Aphiwe Ngwevu