Eating out in Rome was actually stressful. It’s something we weren’t expecting.
My thoughts below apply mostly to the Trastevere area, avoiding the tourist restaurants. I’m sure there’s more to this and we could have spent more time in Rome to get to know it better, but I hope for the casual traveler, this will help soften the blow a bit.
Make reservations beforehand. We called several days in advance to many places and were consistently told they had absolutely no availability at all for any of the days we were there. Not early in the evening or late at night. I honestly find that hard to believe but maybe I’m missing something. Looking back, I would have tried to call a month ahead of time (which still kind of seems outrageous, we weren’t looking at five star restaurants).
Walk ups are possible, but you have to be forward or the staff will ignore you. This was a bit of a shock to the system. I’ve never experienced it before — in any country I’ve been in, even in famously “rude” France, someone at least acknowledges your presence when you are trying to get a table. After having all restaurant staff ignore us, we had to physically flag someone down and ask if they had room. We were mostly treated like a bother and that they were doing us a favor by even talking to us. This wasn’t the case at every place we tried, and I’ll highlight those in a roundup of restaurants later.
We had some really great meals and not everyone was aloof or indifferent. But, I think this is worth noting if you’re traveling to Rome just so you’re in the right mindset. Again, expectations are everything when traveling, so if we’d known that eating out was going to be a contact sport, we’d have been in the right mindset for it.
Just like in Paris, not every place will do dishes justice. While it’s easier to find a decent plate of pasta in Rome than soup a l’oignon in Paris, we still had some mediocre dishes. For the times we had to dip into touristy restaurants, we had much better luck with the pizza (pizza is harder to mess up?).
Have you been to Rome before? I’d love to know if our experience was unique.
Almost Never Clever 
We were in Rome in July of 2013 only for 3 nights and didn’t have trouble with restaurants. Maybe we were in more touristy areas?
I do wonder if the neighborhood was a factor.
Really? I went to Rome for a few days, we were in the middle of the centre/touristy areas mind but we walked around a lot and everything was fine, waiters were friendly, everyone spoke English, there were vegetarian options (in english) and everything tasted amazing. Also we never had to book, were never turned away and always managed to get a table without waiting, and we ate at all times of the day and night. Also pretty much everyone we met (Except the people at the airport) were much /much/ friendlier than you normally find in Britain :p Rome was fantastic, and also weirdly cheap!
I’m wondering if it’s the neighborhood we were in? We pretty much ate dinners in Trastevere most nights.
We were next to the train station, but we did go around the city and ate in random places and ye, never had to book, waiters were mostly friendly and always seated/served us quickly and everything was delicious and fairly cheap 😛