"Best pasta in San Francisco" is four different questions wearing one trench coat. The place that nails a baked lasagna is rarely the place that nails a cacio e pepe, because one is about assembly and patience and the other is about sixty seconds of emulsion under pressure. So, as with pizza, we rank them separately.
Lasagna
Marcella's Lasagneria
Luisa's, since 1959
The Italian Homemade Company
Marcella's is the category's anchor: a Dogpatch shop whose entire identity is lasagna, with the highest-volume lasagna conversation in the city at 95% positive. Its bolognese scores 95% too, so the kitchen travels. Luisa's ties the score on a third of the sample.
Carbonara
Bella Trattoria
Roma Antica
Piccolo Forno
A dead tie at the top: 93% on identical 50-mention samples. Pick by neighborhood. Bella Trattoria's reviews emphasize the guanciale; Roma Antica's emphasize that it tastes like Rome, which its Roman owner would consider the point.
Cacio e pepe
Roma Antica
54 Mint
Ideale
Notice the scores drop. Cacio e pepe is the hardest dish in this post to execute at restaurant pace, and the reviews show it: even the winner sits at 90%, and Ideale's 80% comes with the word "gluey" appearing more than once. If a menu offers it tableside in a cheese wheel, the data says order something else; theater and emulsion rarely coexist.
Bolognese and ragu
Marcella's again at 95% (20 mentions), Bella Trattoria at 88%, and one asterisk worth knowing: Cotogna's ragu scores 100% from just 8 mentions. Eight people is not a ranking, but when all eight rave about the same agnolotti at a Michelin-adjacent room, it is at least a strong lead.
Open the pasta maps →Related
Pizza by style, cioppino (San Francisco's own pasta-adjacent invention), and tiramisu for after.