Diners' Choice: Italian restaurants in San Francisco

OpenTable

Updated June 05, 2025

Looking for restaurants with the best overall Italian cuisine in San Francisco? You’re in the right place. Each month OpenTable analyzes more than 400,000 new diner reviews. We sort the results by category to help you discover new favorites. 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 (735)

$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

Ryan

Dined on Jun 22, 2025

Great food and service - the owners are so friendly, and made this a most enjoyable meal for our family!

Pizzeria Delfina - Pacific Heights

4.9

4.9 (137)

$30 and under

Italian

Pacific Heights

About the restaurant

Pizzeria Delfina is a pizzeria that combines the pizza culture of Naples, Italy with that of modern New York City. Neapolitan pizza is a very specific type of pizza, as is that of New York City. By combining the best elements of both, Pizzeria Delfina has created a style of pizza that is all its own. James Beard Award winners Annie and Craig Stall created this restaurant as a way to fuse their two favorite locales and flavors.Pizzeria Delfina's pizza recipes include both classic recipes and new interpretations. There is the traditional panna pizza with tomato sauce, cream, basil and shaved parmesan as well as the clam pie with cherrystones, oregano, tomato, pecorino romano and hot peppers.

Top review

JaniceVIP

Dined 6 days ago

Food is very fresh and well prepared. Some portions are on the small side. Definitely worth a visit!

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Experience

Jolie-Laide x Pizzeria Delfina BTG Takeover

Pazzia

4.9

4.9 (307)

$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

SoniaVIP

Dined 3 days ago

Great food. Fresh and yummy. Wonderful service. Good strong cocktails and decent wines. Neighborhood gem!

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Popular dish

Pazzia

Popular dish

Linguine alle Vongole

Lupa Trattoria

4.7

4.7 (1092)

$30 and under

Italian

Noe Valley

About the restaurant

Situated in the congenial San Francisco neighborhood of Noe Valley, Lupa is a classic Italian trattoria with comfortable neighborhood charm, affordable prices, and destination-caliber cuisine. Using the best available local ingredients, Chef Stefano Coppola creates a seasonal menu featuring classic dishes from his home in Rome.

The menu is based on the Italian tradition of preparing food - combining simplicity with the best ingredients of the season, including quality olive oil, locally grown local vegetables and fruits, and seasonal specials of seafood, poultry, meat and game. Our bread and pastas - gnocchi, tagliatelle, pappardelle, tortelloni, and ravioli are homemade on premise.

In addition to the regular menu, our specials menu features different soups, antipasti, pastas, and main courses.

Beyond a passion for authentic Roman cuisine, our friendly Italian staff work from their hearts to make your visit comfortable and enjoyable.

Top review

GaryVIP

Dined on Jun 17, 2025

We love Lupa! It is an exceptional neighborhood Italian restaurant. All of their pastas are delicious. I am especially fond of the NY Steak - it's one of the best deals in the city.

Frascati

4.9

4.9 (2616)

$31 to $50

Italian

Russian Hill

About the restaurant

Frascati is a Mediterranean style bistro, located in one of San Francisco’s most desirable neighborhoods – Russian Hill. When a guest walks through the door of Frascati, he or she is initially treated to a friendly and comfortable dining room. Frascati encompasses a truly European aura, but is also a cozy, San Francisco neighborhood bistro. This tri-level restaurant features warm colors, high ceilings, antique light fixtures and street views of cable cars clanging up and down Hyde Street. The natural light and energetic atmosphere all convey a lively spirit.

Our cuisine is inspired from the Mediterranean coast and has strong Californian influences. The menu shifts frequently to utilize the best and freshest ingredients any season has to offer. Also, we pride ourselves on all of our house made desserts and ice creams.

Of equal importance, Frascati has become known for having an eclectic wine list which nicely complements the food.

Top review

OpenTable Diner

Dined 4 days ago

Very nice experience and great food. Service is very friendly, great little spot

Seven Hills

4.9

4.9 (2538)

$31 to $50

Italian

Russian Hill

About the restaurant

Welcome to Seven Hills. We are a rustic neighborhood bistro offering regional Italian food, located in the Russian Hill Neighborhood of San Francisco. We serve great fresh affordable food. Our emphasis is on homemade pastas. Our wine list is small but extremely well thought out and complements our cooking style. We look forward to taking care of you and your guests. If you can not find what you are looking for online please call us directly at the restaurant. See you soon!

Top review

KurtVIP

Dined 5 days ago

Everything was perfect. From host to server to food to wine. NY steak cooked to perfection (medium rare). Wine suggestion was spot on. Excellent restaurant for any occasion.

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4.8

4.8 (1251)

$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

HaleyVIP

Dined 2 days ago

Delicious food! The farro salad was super yummy and the burger was amazing! So was the mushroom pizza.

Cafe Tiramisu

4.8

4.8 (1590)

$31 to $50

Italian

Financial District / Embarcadero

About the restaurant

We are offering our food and services in a new way, one that safely creates jobs for our employees, and still provides that quintessential experience only Cafe Tiramisu can.
At Café Tiramisu our pasta and salads as a takeaway experience with authenticity, carefully selected ingredients for maximum taste and freshness to provide healthier options for all of our customers to satisfy vegan, and vegetarian options! ready to be collected or delivered to you.
Remember to save room for one (or more) of our dessert options.

Top review

Gerald

Dined 5 days ago

First time- definitely return! Good food, fairly priced.

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Popular dish

Tiramisu 'Pick Me Up'

Little Original Joe's -- Marina

4.8

4.8 (124)

$30 and under

Italian

Marina / Cow Hollow / Presidio

About the restaurant

Welcome to Little Original Joe's -- an Italian-American neighborhood eatery featuring pizza, pasta, and parmigiana in San Francisco's Marina neighborhood! Limited reservations are available for up to 6 guests -- we look forward to seeing you soon!

Top review

Bridget

Dined 6 days ago

Little OJ's is an elevated neighborhood staple, and it's delicious and the service is great every time I come in!

Serafina SF

4.8

4.8 (504)

$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

AlfredoVIP

Dined 4 days ago

Serafina is such a gem in the city, great service, delicious food and always worth coming back

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