Is Air conditioning needed in April ?

Could depend on where you are going. Please identify.

Probably don't need in AC in April, but where in Italy? Northern is cooler than southern. And usually you don't pay if you don't use it.

Gerald,
It's highly unlikely you can even get A/C in April in Italy. Use is regulated and A/C isn't even turned on until later in May, although places with independent wall units can get around the regs. A ceiling fan might be welcome, depending on where you are staying. FWIW we didn't need to turn on our A/C at home in Rome until mid-June. Even so, you should not have to pay if you don't use it. Confirm that in advance.

Gerard, As someone else mentioned, it would really help to know which parts of Italy you'll be visiting. I've been in Rome in April when A/C was definitely needed (I can't remember whether the Hotel had it switched on or not?). On another trip to the Val d'Orcia region of Tuscany in May, it was somewhat chilly and wet, so A/C wasn't needed. Cheers!

Absolutely not.

I'd not stay in a place that charges extra to turn on the a/c. Some hotels, though, control it centrally. April is a bit of a lottery in Italy. Can be cool like this year, can be very warm like 2009.

Yes, I remember 2009 well!!! 2 weeks (Rome/Florence/Milan) My husband's first trip to Italy. We arrived 2nd week in May....an African Heat Wave they told us....in the mid 90's! We just settled into early and morning walking sites, peaceful lunch, afternoon museum where it was cool then a nice nap. Back out again in the evening when it was slightly cooler. Our hotel was air conditioned. Our hotel told us businesses can use a/c earlier than residents. At first we could not get our a/c to come on in our room....apparently, the maid had failed to completely seal our window - once that was done we were set.