Originally Posted by Bevdeforges

If Italy has no agreement with your home country, you'll have to go through a driving school. But shop around a bit. I had to attend driving school when I went for my license in Germany, but found a very nice driving instructor who agreed to let me do a few practical driving sessions so he could help me with the differences between my US style of driving and the rules in Germany.

He also said that I could sit in for free on the classroom sessions if I wanted to.

Generally, in Europe you seem to have to have a driving school backing your application and you generally have to take the driving test in the driving school's car. It's the driving school that makes arrangements for your tests (written and driving) and they can ask to see if you can take the tests in a language other than Italian (usually there is an additional charge) - if you'd be more comfortable in English or another language.

Although it was expensive having to go through the driving school, I'm really glad I did. I learned quite a bit about the "odd" driving rules here (in Europe in general) and I know I'm a better driver than many other Americans who were able to exchange their licenses without having to learn about the differences in the law.
Cheers,
Bev