Tsitsipas had never won a set in his previous three meetings against claycourt specialist and 11-times French Open champion Nadal, but the Greek drew first blood by saving a break point to hold in the 10th game and take the first set.
Flamboyant Italian Fabio Fognini followed up his shock victory over Rafael Nadal with a 6-3 6-4 win over Serbian Dusan Lajovic to claim his maiden Masters title in Monte Carlo.
Rafael Nadal's bid for the 12th title crashed after losing to Fabio Fognini in the Monte Carlo Masters semi-finals.
Nadal and Djokovic have played each other 50 times, but their last meeting came more than a year ago, when Nadal won in the Madrid Open semifinals. Djokovic leads Nadal 26-24 overall, but Nadal holds a 13-7 advantage on clay.
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