My wife and I just returned from this vacation 10/15/11. Overall we would rate the vacation average.  We traveled American Airlines from LAX to Chicago to Rome going; and Rome to NY To LAX returning.  The flight to Rome took 4 hours to Chicago plus a 2 hour lay-over then 9 hours to Rome.  So you will be traveling a minimum of 19 to 20 hours from your house to your hotel in Rome.  The return trip is 10 hours from Rome to NY, a 4 1/2 hour lay-over in NY then 6 hours to Lax plus the time to get home.  Needless to say it is a long difficult trip.
We walk 2 to 3 miles everyday with pretty steep hills; we still found that we were very tired most days due to the walking required.  Some of our fellow travelers needed to skip some activities or ride a taxi to get where we were walking to.  The streets are uneven and some are very challenging to climb.  Good quality walking shoes are a must.  Some were wearing sandals or dress shoes and suffered.  Get on an exercise program BEFORE you go.
Men should know that many of the churches on the agenda will not permit shorts or sleeveless shirts.  
The breakfast selection in the hotels is virtually the same; runny scrambled eggs, undercooked bacon, pastries or buns, canned fruit, cereal (no bananas), lunch meats and cheese and coffee.
Lunch is on your own.  Most dinners are on your own.  If you choose to eat in a decent restrurant expect to pay $100 per couple plus drinks and dessert.
The hotel rooms are adequate.  Women will need to bring an electrical converter if they want to use a 110v hair dryer; the hotels do not provide converters.  My wife tried to use the hair dryer provided and found that it kept kicking off as it heated up.  Some of the bathrooms did not have shower curtains.  If you ask for a queen bed, you will get two twin beds pushed together.  The beds are very firm and the pillows are very flat.
Expect to spend an extra $1,000 for meals and side trips.
Most churches will not allow photography.  Oddly enough, St. Peters does allow photography.  If you are scheduled to be in Rome on Wednesdays St. Peter's square and Cathedral will be packed with tourists as the Pope makes appearances on that day.
Watch out for theft and pickpockets.  We witnessed 3 thefts of purses or gift bags in 10 days.  All of the tourist spots are over-run with gypsies and African illegals.  If you are constantly alert you will be okay.
You may be frustrated with the limited time you will spend in each location.  You will see many locales but time will be short at each.  

Recommended: Yes

Best Suited For: Couples
Tour format: Bus
Tour type: Group
Tour length: Over a Week