Besides the euro, no other currency is officially accepted in Italy, although major currencies like US dollars and pounds can easily be exchanged for euros at bureaux de change in tourist centres like Rome and Milan.
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It's always wise to carry a small amount of cash for smaller cafes and restaurants, some public transport options, and taxis who may not accept credit card payments. We once visited the same restaurant 5 years in a row, only to discover each time that their card machine was out of order!
All those who enter the Italian territory and bring with them cash over the limit of 10,000.00 Euros must declare it to the Customs and Monopoly Agency (ADM). The law also considers easily convertible instruments such as traveller's cheques, shares or bearer bonds as cash.
Bring $100-200 USD cash, but keep it stashed away and don't change into Euro. It's only to be used as a fallback if every ATM in the country is out of order at the same time. Use ATMs to withdraw Euro from cash machine in the airport upon arrival, and replenish your Euro supply at an ATM when you run low.
In Italy, cash is still preferred in most restaurants, cafes and other establishments, although credit and debit cards are becoming more widely used throughout Italy and are an increasingly convenient way to pay for things. Visa and Mastercard are widely accepted, although American Express is not.
Compared to many other countries in Europe and around the world, Italy remains a predominantly cash-driven society. While you can still use your bank card in many establishments, many Italian restaurants, cafes, shops, and hotels still prefer cash.