Foreshocks in the form of microseismicity are among the most powerful tools to study the physical processes that occur before main earthquakes. However, their detection and precise characterization is still sparse, especially for small‐to‐moderate‐size earthquakes (⁠Mw<6⁠). We present here a detailed foreshock analysis for the 7 November 2019, Balsorano, Italy, normal fault earthquake (⁠Mw 4.4). To improve the detection of the microseismicity before and after the mainshock, we use six three‐component broadband receivers at distances of less than 75 km from the targeted seismicity, through template matching. To improve the understanding of the physical mechanism(s) behind the earthquake initiation process, as well as other accompanying phenomena, we also detail the spatiotemporal evolution of the sequence associated with this medium‐sized earthquake, using waveform clustering and hypocenter relocation. Clear differences between foreshocks and aftershocks are revealed by this analysis. Moreover, five distinct spatiotemporal patterns associated with the different seismic activities are revealed. The observed spatiotemporal behavior shown by the foreshocks highlights a complex initiation process, which apparently starts on an adjacent unmapped antithetic fault. Finally, the aftershock activity comprises four different clusters with distinct spatiotemporal patterns, which suggests that the different clusters in this sequence have distinct triggering mechanisms.