Best Italian Restaurants in Pacific Heights
5 hand-picked restaurants, critic-reviewed and ranked
Last Updated: February 2026
Our Top Pick
The Tailor's Son
Lively Milanese classics with well-heated patio tables on Fillmore.
Notable Picks
8.3
Vibes:
Outdoor Dining Oasis
Trendy Table Hotspots
Girls Night Out Approved
Family Friendly Favorites
A bright Milanese-leaning trattoria from Adriano Paganini with risotti, verdure, and cocktails. Heated sidewalk seating keeps the energy high without sacrificing comfort.
Must-Try Dishes:
Risotto alla Milanese, Vitello tonnato, Tagliatelle al ragù
What Makes it Special: Lively Milanese classics with well-heated patio tables on Fillmore.
Neighborhood standby for thin, lightly blistered pies and seasonal antipasti that work for kids and adults alike. Quick service, sidewalk seating, and shareable salads make it an easy family dinner play.
Must-Try Dishes:
Margherita, Prosciutto Arugula Pizza, Burrata with Seasonal Toppings
What Makes it Special: Craig & Annie Stoll’s Pac Heights outpost (since 2008) for crisp, Neapolitan-inspired pies.
8.1
Since 1985, this cozy Roman-Southern Italian spot has served neighborhood faithfuls. A couple of outdoor tables extend the intimate dining room onto Fillmore.
Must-Try Dishes:
Bombolotti sugo di carne, Carpaccio di zucchini, Tiramisu
What Makes it Special: Old-school, family-run trattoria with a few coveted sidewalk seats.
Worthy Picks
#4
SPQR
7.9
A Michelin-starred Pacific Heights room built around Roman technique—refined pastas, pristine seafood, and a tasting menu that rewards the full commitment. The 45-seat space runs loud when full, so window tables offer the best balance of energy and conversation. Works for couples and small celebrations willing to lean into a deliberate, course-driven pace.
Must-Try Dishes:
Tasting Menu, Octopus, Bucatini
What Makes it Special: Michelin-starred Roman-inspired cuisine with a celebrated tasting menu and wine pairing program in an intimate Pacific Heights setting
#5
Pinsa Rossa
7.7
Modern Roman pinseria and beer bar featuring a 72-hour fermented dough that eats lighter than traditional pizza. Counter-friendly service and a tight antipasti lineup make it an easy neighborhood fix.
Must-Try Dishes:
Margherita Pinsa, Fiocchi di Pasta alla Pera, Arancini
What Makes it Special: Roman-style pinsa with airy, 72-hour fermented crust and taps.