Traveling companions are leaning toward "Roman Strolls" for a skip-the-line tour, but I can't seem to find any reviews on them beyond their website. Anyone used them before?
You can book a tour directly with the Vatican Museum itself. You go to a different entrance with essentially no line. Check out their web site, send a fax indicating your preferred dates and times, and you will get a confirmation fax in 24 hrs. We did this in October and it worked great. So, unless they have changed their procedure, no need to use an outside agency.
BTW, the Vatican Museum is as well organized as any tourist stop you will find anywhere: ticketing, tour guides, earphones, souvenir stands every 100 feet, snack bars, pizzeria, etc., etc. Amazing!
I used myvaticantours.com and passing the lines gives you much more time later in the day after the tour.