He was born in Abruzzo, Italy and immigrated to St. Louis in his late teens. In 1922, Fresina joined a gang headed by Pasquale Santino, which began operating in the city around 1910. Fresina and his wife Louise Cinardi lived at 2716 Semple Avenue in St. Louis, Missouri. In 1922, Fresina was charged with the murder of Joe Bucceri who dying accused Fresina of his murder. Fresina was also a suspect in the murder of his former saloon partner Clarence Schnelle in 1927 and Angelo Corella in 1928. After Pasquale Santino was murdered in 1927, Fresina took over his gang, which specialized in extortion and bootlegging and became allied with a splinter group of the Green Ones led by Tony Russo. Together they waged a battle with the Green Ones.