The pressure evolution of the local structure of Fe2O3 hematite has been determined for the first time by extended x-ray absorption fine structure up to 79 GPa. The comparison to the different high-pressure forms proposed in the literature suggests that the orthorhombic structure with space group Aba2 is the most probable. The crossover from Fe high-spin to low-spin states with pressure increase has been monitored from the pre-edge region of the Fe K-edge absorption spectra. The "simultaneous" comparison with the local structural changes allows us to definitively conclude that it is the electronic transition that drives the structural transition and not viceversa.