Italian restaurants in America today are many and varied, and much more authentic and/or regionally focused and/or contemporary in style than they used to be. It’s possible to find real Ligurian, Roman, Sicilian, and Calabrian dishes around the country now — not just their Italian-American approximations. At the same time, restaurants like La Tavola Trattoria in Atlanta, Scampo in Boston, and Vetri in Philadelphia are expanding the definitions of what Italian cuisine can be.

But meanwhile…There’s nothing wrong with Italian-American food. It’s not a bastardization of the real thing, it’s its own entity (like Tex-Mex in comparison to true Mexican fare), with legitimate cultural and culinary origins. Besides, who among us doesn’t sometimes crave spaghetti with meatballs, chicken scarpariello, or veal parmigiana?

The good news is that there are still plenty of old-school Italian places (sometimes referred to as “red sauce restaurants”) going strong around the U.S. — establishments serving the familiar dishes that we’ve come to know and love. 

To determine the top 50 examples, 24/7 Tempo reviewed and extrapolated from lists and rankings on numerous food and general interest sites, including Eater, Yelp, The Daily Meal, Fodors, Business Insider, Thrillist, Food Network, Foursquare, Forbes, and Gayot, as well as a wide range of regional and city-specific sites.

Our choices cover some 24 states, with more than one example in Italian-American restaurant capitals like New York City, Chicago, Boston, and San Francisco. The majority were started by immigrants from Italy, though a handful are owned by non-Italian Americans or chefs and restaurateurs from other countries.

Click here to see the top 50 old-school Italian restaurants in America

While some of the places on our list serve pizza, we eliminated those that are primarily pizzerias. (Not that there’s anything wrong with pizza, of course. See our list of the 25 best pizza places in America.)

Some of our top choices are more than a century old, while one dates from only last year, though it has an undeniably old-school feeling. Occasionally, the founders and/or customers were connected to organized crime. Many have counted celebrities among their clientele — often Frank Sinatra, though also, in one instance, our current president. (Here is a list of Joe Biden’s favorite foods.)

All have interesting stories to tell and do what they do extremely well.