Tuilagi, 22, has played only 70 minutes for Leicester since suffering a badly torn pectoral muscle in September but comes in for Alex Goode and will cover the centre and wing positions.
"Manu trained well with us last week and is up to speed with the way we want to play," England coach Stuart Lancaster said on Thursday.
Mako Vunipola will replace Joe Marler at loosehead prop because the Harlequins forward's wife is due to give birth to their first child over the weekend.
"We have prepared for being without Joe," Lancaster said in a news release. "It is important that Joe is with his partner at this exciting time.
"Family must always come first and everyone in the squad wishes them well."
England, France and Ireland all have six points going into the final round of matches but Ireland's far superior points difference means England would need a monumental win in Rome to overhaul them should the Irish win in Paris.
If France win that game then any England victory in Italy should be enough to secure only their second title since 2003.
Team: 15-Mike Brown, 14-Jack Nowell, 13-Luther Burrell, 12-Billy Twelvetrees, 11-Jonny May, 10-Owen Farrell, 9-Danny Care; 8-Ben Morgan, 7-Chris Robshaw (captain), 6-Tom Wood, 5-Courtney Lawes, 4-Joe Launchbury, 3-David Wilson, 2-Dylan Hartley, 1-Mako Vunipola.
Replacements: 16-Tom Youngs, 17-Matt Mullan, 18-Henry Thomas, 19-Dave Attwood, 20-Tom Johnson, 21-Lee Dickson, 22-George Ford, 23-Manu Tuilagi.
