Diners' Choice: Italian restaurants in San Francisco

OpenTable

Updated 05 October 2026

Looking for restaurants with the best overall Italian cuisine in San Francisco? You’re in the right place. Each month OpenTable analyses more than 400,000 new diner reviews. We sort the results by category to help you discover new favourites. It's a great partnership: you reserve, eat, and review. We listen...and deliver the results for all to benefit. Enjoy!

Caffe Macaroni

4.9

4.9 (750)

$30 and under

Italian

North Beach

About the restaurant

Chef & co-owner, Mario and his delightful wife, Stephanie, have a knack for making you feel as if they are cooking and serving just for you at this super-reasonable North Beach nook offering robust Southern Italian fare reminiscent of his native Naples; whether you’ve snagged an outdoor table or are in the small, casual interior, it delivers a pasta fix. The menu changes daily to ensure freshness.

Top review

SeanGold

Dined on 10 Oct 2026

As always the best Italian restaurant in north beach.

Acquerello

4.9

4.9 (2207)

$50 and over

Italian

Pacific Heights

About the restaurant

For 36 years, Acquerello has offered an unparalleled Italian fine-dining experience in San Francisco’s Nob Hill neighborhood. The restaurant, operated by Giancarlo Paterlini and Executive Chef Suzette Gresham, has been heralded for its cuisine, wine, and service. Keeping ahead of the ever-changing dining scene in San Francisco, Acquerello showcases its brightest young talent in the kitchen as well as with its wine program. “At Acquerello, we believe that refined luxury is always in style. Our desire is to provide our guests an experience of classic and contemporary Italian tastes in an elegant dining atmosphere.”

Acquerello has received countless awards, including two Michelin stars since 2014 and one Michelin star since the first-ever 2007 Bay Area guide. Our extensive Wine list is the recipient of the Wine Spectator Grand Award in 2012-present.

Top review

Leon

Dined 2 days ago

Delightful experience, food and service were great and atmosphere was enjoyable able to have a quiet conversation without the usual restaurant noise level.

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Experience

October Tasting Menus | $100 Deposit per person

Experience

Nov/Dec Tasting Menus | $100 Deposit per person

Experience

Four-Course Menu | $100 Deposit per person

Fiorella Clement

4.9

4.9 (1325)

$30 and under

Italian

Richmond District

About the restaurant

Fiorella is a Neighborhood Italian restaurant in the heart of the Richmond district. We serve wood fired pizza, pasta, antipasti & Italian vino in a casual neighborhood setting.

Please note that reserving a "Standard Table" means an indoor table. If no outdoor options are showing at your desired time, we may not have outdoor availability.

If multiple tables are reserved for the same party, we cannot guarantee you will be seated together. Separate reservations will be treated separately, and will be seated based on availability. If you are looking for a group reservation, please visit our website and submit an inquiry.

Top review

BonnieGold

Dined today

We enjoyed dinner very much. Food is very good! Loved the arancini appetizer, my Negroni was great, and the rigatoni in bolognese sauce was terrific. Also enjoyed the luscious chicken cacciatore. Desserts were decadent - go for the chocolate budino! Our server was friendly, helpful and attentive. It can be noisy - lots of hard surfaces. Wish there was a seat cushion on the bench seating.

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4.8

4.8 (2783)

$31 to $50

Italian

Russian Hill

About the restaurant

Welcome to Seven Hills, a rustic neighborhood bistro offering regional Italian cuisine in San Francisco’s Russian Hill neighborhood. We serve fresh, approachable food with an emphasis on our house-made pastas. Our thoughtfully curated wine list is designed to complement our cooking style.

Please note: To help us accommodate all of our reservations, parties of 2 are allotted 1.5 hours for their dining experience, and parties of 4 are allotted 2 hours. Only complete parties will be seated. We appreciate your understanding and cooperation.

If you cannot find the reservation you are looking for online, please call us directly at the restaurant. We look forward to taking care of you and your guests. See you soon!

Top review

AmandaGold

Dined 3 days ago

This is one of the best places in the city to eat. Absolutely delicious. Never disappoints and has great ambiance.

FINO

4.9

4.9 (67)

$31 to $50

Italian

Downtown / Union Square

About the restaurant

Inside the historic Andrews Hotel, Fino offers classic formal Italian dining in a warm room with high ceilings and architectural detail. Antipasti, house-made pastas, seafood, and meat entrées pair with a curated wine list. The restaurant holds a TripAdvisor Travelers' Choice Award.

Top review

Michael

Dined today

Loved this place. Can't believe it's been for so long and I never heard of it till recently. The underground Muni trains were out of service last night. We were 30 minutes late. Not only did they accommodate our need for speedy service to make curtain call at the Curran, they got us through the meal with 20 minutes to spare. Excellent service Excellent food. Great, old world charm atmosphere. Can't wait to return

Pazzia

4.8

4.8 (404)

$31 to $50

Italian

SOMA

About the restaurant

Authentic Tuscan restaurant serving seasonal Italian fare with all the convivial charm and allure of the Florentine neighborhood of San Frediano.

Opened in 1998 and located in the heart of what was then considered the city’s industrial warehouse district, tucked away on SoMa's Third Street, PAZZIA's buzzing dining room and outdoor patio quickly became a local favorite and destination spot for those “in the know”.

From fresh house made pasta, thin crust pizza, grilled meats and seasonal specialties to classic Italian aperitivo cocktails and convivially energetic Italian staff, PAZZIA is the perfect spot for a date night, family gathering, office function or delicious night out with friends.

PAZZIA offers indoor seating in a spacious dining room with banquette seating and views of the open kitchen, a more intimate lounge room with bar seating and tables around a fireplace and sheltered outdoor tables with heat lamps along the wide front patio.

Top review

KatGold

Dined 2 days ago

Branzino fabulous, spinach and ricotta balls are amazing. Been going here for 25 years. Maximo so welcoming and professional, Julia as well, always a family feeling and amazing food. Best Italian food in SF…

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Popular dish

Pappardelle sul Cinghiale

4.8

4.8 (101)

$30 and under

Italian

Mission District

About the restaurant

Nestled in the vibrant Valencia corridor, we are more than just a restaurant. We are a labor of love by a tight-knit team – meet our visionaries: Nick Kelly, the Executive Chef, whose culinary expertise brings the flavors of Italy to life with every dish; Saul Magana, the General Manager/Sommelier, orchestrating seamless dining experiences with a personal touch; as well curating an exquisite selection on the wine list to complement every bite.

At Barberio Osteria, our ethos is simple yet profound: to create an ambiance where every visit feels like a celebration. Whether it's a joyous milestone or a casual Monday evening craving, our doors are open wide, inviting you to savor the essence of Italian hospitality. Picture yourself unwinding with a perfectly al dente pasta and a glass of fine wine, enveloped in an atmosphere that effortlessly balances elegance with familiarity.

Top review

MichaelGold

Dined on 11 Oct 2026

Each visit is excellent in all respects!...we will be back as soon as possible!!

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4.8

4.8 (2688)

$30 and under

Italian

Noe Valley

About the restaurant

We are currently open for both Indoor and Outdoor dining.
- San Francisco can get very chilly at night. Please do not forget your jacket.
La Ciccia is a cozy and intimate restaurant located on the edge of Noe Valley. The chef is committed to use the freshest and the most authentic ingredients from Sardinia resulting in pungent, lively, flavorful food. The all Italian wine list, 150 labels selection represent every Region with more than a quarter devote to Sardinia in order to pair the traditional earthy flavors as well seafood influence of Sardinia cuisine. La Ciccia is a tribute to Sardinia an experience not to be missed.

Top review

Shauna

Dined today

The waiter told us the specials and they sounded really nice. People sitting next to us ordered the same dish but had different opinions with their meal, would have been nice if the waiter had told us all of the options. The hostess was amazing. The Halibut was seasoned to perfection.

Serafina SF

4.8

4.8 (670)

$31 to $50

Italian

Downtown / Union Square

About the restaurant

Serafina is a little gem of a restaurant, perched on top of Nob Hill, with views overlooking the city and Bay Bridge. We were recently awarded the prestigious Gambero Rosso as one of the best Italian restaurants in the US. Serafina was owner Maurizio Bruschi’s grandmother, and the name of her eponymous restaurant in the heart of Trastevere (Rome), where Maurizio first began making pizza at the age of 14. The executive chef is Umberto Cannarsa, a successful chef from Rome, who left his own restaurant in Rome to work with Maurizio again. The menu offers everything, including vegetarian options, but specializes in innovative Italian fish dishes, including fresh calamari, stuffed with olives, escarole, anchovies, drizzled with a potato leek sauce, as well as homemade pastas and dolci. The space is warm and elegant, where neighbors and friends can come together.

Top review

SidGold

Dined on 17 Oct 2026

Absolutely perfect experience. Real Italian food and away from the crowds of central North Beach. One of our favorites in the city.

Bistro Central Parc

4.8

4.8 (1190)

$30 and under

Italian

North Panhandle / USF

About the restaurant

Our executive chef is excited to present their vision to you and all our guests. With the utmost romantic atmosphere, our caring and committed staff make sure you have a fantastic experience with us!

Top review

Paula

Dined 1 day ago

We always have a great meal here. The bistro is a neighborhood gem. Fabulous service, consistently good food. The Early Bird special salad, entree and dessert is incredible value. We love eating here.

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Experience

Optional $25 | Early Bird Dinner | 3-COURSE

Experience

Optional $45 | 12oz Ribeye Steak Dinner | 3-COURSE

Experience

Bottomless Mimosa Brunch

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