@Jack79 – I disagree, but obviously this is a matter of opinion. My mom lives in Italy (in the Cinque Terre). I’ve had occasion to visit Florence, Genoa, Pisa, Sarzana, Milan, Orvieto, and Assisi, as well as many more smaller places, lesser-known cities, and the countryside. The cities and world-famous destinations are full of tourists year-round and this affects the quality of one’s visit. It means higher prices, scarcer availability of great restaurants, long lines, scenic pictures with random people in them, etc.
I personally think it’s worth dealing with the tourists to see the things at these destinations, at least once in your life. However, the smaller, less-touristy places are where the heart of Italy lies.
For example, we took a drive down from the Cinque Terre so my then-girlfriend could make a pilgrimage to Assisi for her devoutly Catholic mother. We took the autostrada down and stayed with friends in an amazing villa about 20 minutes outside of Orvieto. On the day of our pilgrimage, we rented a car in Orvieto and drove to Assisi. It was a great drive and a great trip and both of us loved seeing the towns and villages we’d never heard of, but which obviously had loads of history. Pretty much any village, town, or city you go to will have some piece of history, whether it be a castle, towers, mills, churches, monasteries, bridges (there is a still-functional Roman bridge about 30 minutes from my mom’s in the country), Roman aqueducts, you name it.
Then, on our way back home to the Cinque Terre, we decided to see the countryside and took the non-autostrada route (my brain is a bit foggy, can’t remember what they call it). We ended up having one of the absolute best meals I have had in Italy over the 12 or so years I’ve been going there. On the autostrada, we’d have eaten crappy food in the Autogrill (a very crowded and lower quality version of Sheetz).
Not to mention, the scenery was amazing and worth the bit of extra time it took us to get home. Sticking to the cities, you miss quite a lot. I think of all the unique opportunities and experiences I’ve had there and most of them occurred off the beaten path. :)