Just got back from 2 weeks in Tuscany, and since credit card questions come up a lot here, some observations: The only place where our US credit cards would not work was at an unmanned gas station on a Sunday, where the machine required a "Chip and pin" card (i.e. a smart card). In that case, we had to use cash to get gas. Our regular magnetic stripe cards worked everywhere else: shops, restaurants, autostrada toll booths (even for small amounts), etc. We used a Capital One card that doesn't charge fees for international transactions. I also have a UK "chip & pin" Visa card and it wouldn't work at the gas station either, so there's a chance it was a more general problem
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