The 10 best Italian restaurants in San Francisco

The country's first pinseria opened in SF in 2015, serving ancient Roman flatbreads made from a blend of rice, soy and wheat flour imported directly from Rome. Similar to pizza, but low-fat, low-calorie and easier to digest, it’s topped with classic pizza toppings such as tomato and mozzarella as well as enticing ingredients like artichokes, crispy guanciale and porcini mushrooms. Start your meal with a salad or a selection from their large list of Italian cheeses and cold cuts.

Staffan Terje and Umberto Gibin are exceptional restaurateurs with a true passion for the food of Piemonte and Liguria. While Gibin manages the front of the house, Chef Terje sources the best quality ingredients and never fails to deliver soul-satisfying meals. House made pastas are a specialty including tajarin, handcut thin tagliatelle with ragu of veal and pork salsiccia and supple plin, a stuffed pinched pasta. Happy hour begins at 2 pm weekdays and offers hearty pastas, fried green beans and chicken wings.

You won’t find pizzas at this particularly wallet-friendly and lively Italian restaurant which specializes in dishes from the Emilia Romagna region. Dig into a piadina or cassone, traditional toasted flatbread sandwiches stuffed with a variety of cheeses, vegetables and meats. Homemade pasta dishes include fantastic lasagnas and gnocco roll, gnocchi dough filled with spinach and ricotta topped with either Bolognese or marinara sauce.

This completely unpretentious California-Italian restaurant offers a menu of antipasti, beautifully blistered pizzas, salads, pastas and a noteworthy calzone. The vibe is friendly and casual and it’s popular with young couples, families and groups but also offers seating at the bar for singles and those without a reservation. The restaurant feels like a love letter to the Bay Area thanks to the use of local and seasonal ingredients and hip custom wallpaper featuring homegrown legends including rappers, a news anchor and political activists.

This cozy Noe Valley restaurant showcases the cuisine of Chef Massimilliano Conti's homeland, Sardinia, paired with a thoughtful Italian wine list. Don't miss longtime greats like the octopus stew or spaghittusu cun allu ollu e bottarga (spaghetti in spicy oil and bottarga).

Now celebrating 30 years, Michelin-starred Acquerello is a fine dining jewel. Chef and co-owner Suzette Gresham’s prix fixe with three, four or five courses and seasonal tasting menus are complemented by a world-class Italian wine cellar overseen by co-owner Giancarlo Paterlini. A quiet and elegant restaurant with a luxurious feel, it’s a place to indulge in decadent dishes like the signature ridged pasta with faux "foie gras," black truffle and marsala and an all-Italian cheese course.

Dream-team chef Matthew Accarrino and wine director Shelley Lindgren stay at the top of the restaurant scene with ever-changing dishes like the chestnut gnocchi in poultry sugo or kabocha squash raviolini in coconut milk, kaffir lime and pumpkin seeds. Thankfully, there is a pasta tasting menu if you want to try a few.

Tuscan-born sommelier and owner Claudio Villani ensures gracious Italian hospitality, smart Italian wine selections and a comfortable elegance at AltoVino. Try the ascolane (fried olives filled with braised oxtail and Parmesan) and housemade pastas, like the squid ink raviolini filled with halibut mousse. 

A modern Italian trattoria, 54 Mint is open for lunch and dinner, and also offers a daily version of happy hour “aperitivo” starting at 4pm with bitter Italian cocktails and tempting nibbles like deep fried smelt or suppli, tomato and basil rice croquettes with molten smoked mozzarella. The focus of the restaurant is on classic Roman dishes including trippa alla Romana (slow-braised tripe, pancetta, tomato, mint and pecorino) bucatini all ‘amatriciana and saltimbocca alla Romana.

Good luck snagging a reservation at Che Fico, one of the hottest new restaurants in the country. But if you do get into the light-filled, upstairs taverna, prepare yourself for chef David Nayfeld’s stellar San Francisco-style pizzas (try the pineapple-fermented chili!) and ambitious, irresistible pastas, like a recent tomato leaf cappellaci pasta filled with baccalá (salt cod) and accompanied by fennel, olive oil-braised tomato and taggiasca olives.