Typically an Italian meal consists of four courses (starter, first course, main course, and dessert), although this can be stretched to eight courses or more (starter, first course, fish main course, meat main course, cheese, and dessert). Do not feel obligated to eat this many courses. I often order just two, particularly for lunch. I normally order just an antipasto (starter) and a primo (first course) or secondo (main course) or if I am quite hungry then just a primo (first course) and secondo (main course). Often meals end with an espresso (never a latte or capuccino after morning).
These are usually cold dishes and can include cured meats, sometimes served with fruit such as melon or figs, marinated or grilled vegetables, salads, etc. Some restaurants simply have a bar of various antipasti and you go and help yourself or a cart they wheel to your table. They are eaten to stimulate the appetite and prepare for the following courses.
Primi (First course)
This is usually a starch based dish like pasta, risotto, polenta, and pizza. Soup is also considered a first course however. This course is meant to satisfy your hunger and prepare you to enjoy the main course.
Secondi (Main course)
This course is normally a protein based dish such as fish, meat, poultry, or eggs. Fish is normally simply cooked so that you can taste the freshness of the fish. They may even bring you the fish or meat to show you the quality before it is cooked. Whole fish is usually grilled, boiled, or roasted and brought whole to the table. The waiter may debone the fish and make individual servings but they will likely make a show of doing this. Some people like to order both fish and meat in which case a smaller portion of the fish will be brought before the meat course. Main dishes are typically served on their own with side dishes (contorni) ordered separately.
Contorni (Side dishes)
These are vegetables, often served at room temperature, which are accompaniments to the second course. Sometimes salad is served or there is a salad bar to make your own. Typically salads are dressed simply with good quality olive oil and vinegar.
Particularly at home, fruit is served at the end of a meal and a bowl of water is provided to rinse and peel the fruit. Some restaurants will have fruit salad (macedonia) or fragoline (tiny wild strawberries- a must try if you find them!)
There are too numerous to count. Typical desserts include torte (cakes), crostate (tarts), panna cotta (flan), and tiramisu (a coffee and chocolate flavoured pudding). After informal meals, many people will go get gelato (ice cream) at a gelateria (ice cream shop). Children at home are often offered yoghurt.
Formaggi (Cheese course)
A cheese course can be enjoyed before the dessert or instead of the dessert. Typically restaurants have a cheese board or cart with regional specialties which they have sourced from artisans which do not sell commercially.
This is an alcoholic drink to aid digestion and can include grappa, sambuco, amaro, or herbal liqueurs like genepy.
Normally Italian restaurants are quite flexible so that if you would like your food prepared a bit differently and you ask nicely, they will typically accommodate your request. Also if you want something not on the menu but they have the ingredients and it is not a complicated dish to prepare, the restaurant will normally accommodate this as well, particularly if a few different guests are requesting the same thing. See my How to Translate an Italian Menu for potential dishes you could simply ask for if you prefer to know in advance what you might like. There are often specials of the day, so if possible as the waiter. Italians typically discuss the theoretical menu with the waiter so don’t be embarrassed to ask questions. Italians from other regions are not informed of other region’s dishes either so will also ask questions. In my experience, if you are nice and are genuinely interested in Italian food, language, history, or culture, most Italians are friendly, kind, and want to help.
Note that some restaurants add a cover charge (coperta e servizio) to the bill to cover table items such as oil, vinegar, bread, olives, and use of cutlery, glassware, and china. Other restaurants just include this cost into the price of the food. Normally this is written on the bottom of the menu. Normally you tip in addition to this amount depending on how fancy the restaurant. In a trattoria or pizzeria, tip an additional 5% or round up to the nearest euro (i.e. on a bill of EUR 37, pay EUR 40). In a nicer restaurant then a tip of 5 to 10% would be customary.