do I need an international driver's license

Yes, it's the law. Many rental car companies will not ask for the IDL but if you are stopped by the police in Italy, it's the law. My wife just got hers for her upcoming trip to Italy. You need 2 passport photos and a filled-out form at AAA. You can easily get the passport photos at Walgreens. $15 for the IDL at AAA and extra dollars for the pictures. Also, we just rented a car for my wife and daughter for Tuscany and Umbria. Autoeurope has told us that you now need to carry the full CDW in Italy.

You don't need an International Drivers License to drive in Tuscany or anywhere else. The International Drivers License is a scam, often on the interweb, which makes money by sounding like what you really do need. What you absolutely do need is an International Driver Permit. That is what is available at AAA/CAA offices, and is what the police will want to see. The IDL is a scam, the IDP is the real deal. It is unfortunate that they sound similar, and everybody from North America is used to having a License.

annemarie, I second Nigel's comments. Note the an I.D.P. is used in conjunction with your home D.L., so you'll need to take that as well. You'll also need to be VERY careful to avoid the dreaded Zona Traffico Limitato areas, as there are hefty fines for EACH infraction. You won't find out that you've been "nicked" until several months after you get home. Florence especially has a LOT of ZTL areas, but they're increasingly common in many towns in Italy now. Happy travels!

Yes, Italy requires an IDP (permit), which a lot of people mistakenly call an International Driver's License, for each driver. No matter; if you pick it up at a AAA office, you will end up with the IDP you need. If you have extra passport photos, you can save a little money and time by bringing them with you to AAA. The IDP, as Ken says, is used in conjunction with your home driver's license - so don't leave that at home.

A bit of paperwork, a bit of your time, a couple of passport photos and 15 bucks equals no worries when you get to Italy. It's unlikely you'll be asked for it when getting the car but would be a real pisser if you got the one dude that's having a bad day and insists on it. And while not overly common law enforcement do conduct random stops. They will want it if they stop you. Happened to me 3 times.

You need a permit not a license. Get one from AAA for about $40.00 with photo ID's.
Lorie

I got pulled over in Italy by police. They wanted to see both the international license and my NY license. I had both. Surprisingly, the policeman said he could have given me a ticket because the rental company only gave me a copy of the registration and the law required me to have the original. But he let me off. MY advice is, have all you papers correctly and be polite if they pull you over.