Other than the hostess being a total snob upon our arrival, we had a great experience at Cafe Martorano (our server was much friendlier, so that took the bitterness out of the first impression.)
I went with the pre-fixe menu, which was actually a great price by Vegas standards - $45 for three wonderful courses. Started with the caprese salad (really fresh and tasty), then the tagliatelle with cream sauce, chicken and peas (rich and delicious), and ended the meal with a sweet cannoli.
Our waiter was really friendly and helpful with suggestions - everyone agreed the portions were HUGE (too much, really), but the food was delicious. It's a nice place in the Rio and I'd definitely go again.