Sicily with Bad Knees

I am in my 40s and in good shape, but found Ragusa to be quite steep when walking from the upper to the lower part of the town, and back (to the train station). For that reason, I would not recommend it for you (same as nearby Modica, which is similar in look and feel). But Noto would be lovely if you're looking for a small town - it does have steep side street like other towns in Sicily but the pedestrian drag is flat and very easy to navigate. An even more interesting, and much bigger city is Siracusa which is still within 2 hours away. That would be my first choice, followed by Noto (if you change your mind about Ragusa).

Alternatively, perhaps you can just stay in either the lower OR upper part of Ragusa and just not do the stairs in between. Also, small shuttle buses are an alternative to walking. It's still an incredible town and I enjoyed it very much. The overlook into the lower town is stunning though, but steep. My friend and I chose to walk because we were able to, although it would have been tough if it was any hotter that day.

I strongly believe there is a parking lot in the lower town, you'd have to Google it and see. We arrived by train. With a car, you will have more flexibility. But the lodging itself will probably not be on a flat surface and will require walking up some stairs, so look out for that.

Ragusa is a bi-level town. I walked down and back up on a day-trip, but I imagine there is bus service that would allow you to avoid that extreme change of level. Once you're down on the lower level, I think it's quite flat. Perhaps someone who has spent more time there than I have can comment further.

Modica is built down the side(s) of a ravine, so it wouldn't be a good choice, I don't think. I remember Noto as being rather flat, but the photos are not dead flat. I think I walked uphill from the train station to the town of Scicli, and the photos show some variation in elevation, but I remember the historic core as being reasonably flat.

Let's see what others say, because I'm definitely not totally confident about all this. I don't have knee problems, so I wouldn't necessarily notice hilliness.

Accurate info from Agnes & acraven. We based ourselves In Ortigia (five nights) with flat pedestrian zone. We hired a guide to drive us to Noto, Ragusa & Modica. Our driver dropped us off for a few hours at each town. I agree that Noto’s historic core was reasonably flat. As lovely & historic Ragusa & Modica are, I would consider your unique health limitations. We were slated to return to Sicily this past fall. My husband & myself are in our seventies, but don’t have any restrictions, so navigating hills is not an issue.

I imagine your healthcare provider/Physical Therapist would be a good resource as well.
Best wishes in your planning.

We will be driving from Agrigento, so we really want to stay in the Ragusa area. I’m good with uphill paths, just have problems with stairs.

On a slightly different topic on your thinking, the beautiful Baroque churches in both Modica and Noto are set at the top of very steep flights of stairs. I recall that one of the churches may have had a little tourist train that took people up to the base, but even that may have still required a couple flights of stairs to the entrance. Tourists can also walk on the ramps used by those little trains. You may wish to Google the images to see if you would want to navigate those.

The cathedral in Ortigia has 8 or 10 stairs to the entrance.

We stayed in Ragusa for a few nights, with a car. There is a free parking lot at the base of town. From there you must walk up several flights of stairs to get into Ragusa Ibla, the lower side, where tourist autos are not permitted Our hosts met us in the lot and took us - with our luggage - to the B&B and back down again on departure. Once you're up there, there are inclines, but few stairs. However, if we wanted to use the car during our stay, we walked back down the stairs to the parking lot.

My friend stayed on the Ragusa Superiore side. We were able to drive to her hotel and park, at a price. You'd have stairs to get to Ragusa Ibla.

We have similar issues and found flat Ortigia Island perfect. There were some flat parts to Noto too.

Here’s an alternative that might make Ragusa work for you. We stayed at the San Giorgio Palace Hotel (listed in RS Sicily book). The hotel can be reached from a road along the base of Ragusa Ibla. You can park along this road. I think the hotel may also have a small lot a little further on. From the road, you walk a short way up an incline (I don’t think there were any stairs) to a gate for the hotel. The hotel is built into the hill and has an elevator which will take you up to the level of the main part of town. From here you can get to the far end of the Piazza Duomo. I don’t remember any stairs to get there. I think we took stairs to get to our room, but there are rooms accessible by elevator. You could call the hotel and find out. We took stairs to the dining room for breakfast. Be sure the elevator goes to the dining room floor. It’s a very nice hotel with a delicious breakfast.

Another possible town would be Scicli. It was pretty quiet when we were there but I remember it being flat.

In 2012, I was in my early 60’s, and was in Sicily at Christmastime, following double knee replacement surgery in May. So I wasn’t in the excruciating pre-surgery pain anymore, but was just a few months into my post-surgical recovery. Sicily certainly has its steep uphill and downhill grades!

We didn’t visit Ragusa, but would have, with another week available. We had a rental car. If information about other towns would be helpful:

Erice - our first 2 nights, after stopping at the Segesta ruins en route, was in this incredibly charming town, set high above Trapani. It’s on the opposite (northwest) corner of Sicily from Ragusa, but it’s a truly special place. It had exceedingly tight corners on almost impossibly narrow streets, but we squeezed our small rental car through OK. The streets were tiles, not blacktop, so walking in the small village was, by definition, all gentle ramps. No sidewalks or stairs, just the tiled streets. The Maria Grammatico bakery was just about worth the entire trip to Sicily!

Agrigento - we stayed high up in the town, and had the toughest time trying to get a parking place of anywhere in Sicily. We found curbside spaces some distance from our hotel, but it was a sidewalk descent to the hotel, and an ascent to the car each morning - but no stairs for us in the upper, upper town.

Noto - the parking lot at the low entrance to town was completely full, so we drove up high. There was one parking space along a street otherwise lined with parked cars, It was in front of a house, and a woman came out to complain as we tried to park. There wasn’t a no-parking sign anywhere, but she evidently didn’t want another tourist taking up a residential space. We drove on, and found a spot closer to downtown. Once on foot, it was relatively flat, with a few steps at a time here and there, but not just ramps, although not like the looooong stairs in Caltagirone.

Modica - chocolate heaven! This time we drove from the upper town down to where we stayed in the lower town. So we saw the wonderful upper town from the car, but stayed in the flat lower town - where the chocolate store, and great a restaurant an easy one-block walk from our B&B on the main street.

Your comments have all been very helpful. Thanks, everyone!