I often get asked if a rental car is necessary in Italy. The answer is yes and no. It really depends on where you are going and if you have the patience, courage and sometimes, the stomach. Every time I go to Italy I rent a car. Not only because I have relatives that live in places with little, or in some cases, no public transportation, but because I like to discover new places that are simply accessible more quickly by car. Important when you are on vacation, jamming in as much as you can.
Driving in bigger cities is not impossible, but ridiculous! Not only is it confusing and chaotic, the centers of most cities are controlled. This means that unless you have registered your car with the police, you are not allowed to drive in the controlled areas. If you do, you will get a hefty fine. And they will know as there are cameras everywhere.
If you find yourself travelling to places where a car is necessary, rent the car from the nearest airport. Airport car rental companies are easier to find than ones tucked into cities and it's quicker to the main roads. Plus, it's usually easy to get to airports from the city center by taxi or bus.
On a recent trip, our group of 16 rented four cars. Our intent was to drive from Florence to southern Tuscany. The four drivers walked to the car rental nearby, obtained vehicles after a ton of issues, and two hours later were on our way to pick up everyone else at the hotel nearby. MISTAKE! We had to pay extra to drive in the controlled zone, even for 20 minutes. And once we got to the hotel, there really was nowhere to load the others. We had to drive in their gated courtyard and garden area and once loaded, maneuver the cars backwards out from where we came in. We intended to follow each other to a vineyard about an hour and a half away, but once we hit the first round-about, we all ended up going different ways. Somehow, we all ended up at the right place at pretty much the same time.
Autostradas are wonderful. Fast and efficient, but not free. At the on-ramp you take a ticket and at the off-ramp you pay. The autostrada from Rome to Florence is about 23 Euro.
Driving in the country, the small towns, villages and hamlets are usually pretty well marked. However, in mountainous and curvy areas, guard rails are not always the norm. Pay attention! This is scenic and if you're driving, you must pay attention to the road! It's a bit nerve-wracking to take a mountain curve only to come head-on with a semi-truck who is well versed on this type of road.
Driving will get you to incredible places. If you don't want to hire a driver, a rental car is definitely worth it!