Neapolitan pizza is very popular worldwide and is registered on the traditional specialties guaranteed (TSG) list. This study was aimed at identifying the cradle-to-grave carbon footprint (CF) of a medium-sized pizza restaurant serving in situ or takeaway true Neapolitan pizzas conforming to the Publicly Available Specification (PAS) 2050 standard method. An average CF of ~4.69 kg CO2e
/diner was estimated, about 74% of which was due to the production of the ingredients used (with buffalo mozzarella cheese alone representing as much as 52% of CF). The contribution of beverages, packaging materials, transportation, and energy sources varied within 6.8 and 4.6% of CF. The percentage relative variation of CF with respect to its basic score was of about +26%, +4.4%, and +1.6% or +2.1%, provided that the emission factor of buffalo mozzarella, fresh cow mozzarella (fiordilatte), Grana Padano cheeses, and electricity varied by +50% with respect to each corresponding default value, respectively. The specific carbon footprint for Marinara pizza was equal to ~4 kg CO2e
/kg, while for Margherita pizza, it was up to 5.1, or 10.8 kg CO2e
/kg when topped with fresh cow or buffalo mozzarella cheese. To help pizza restaurant operators select the most rewarding mitigation strategy, we explored how CF was affected by more sustainable buffalo mozzarella cheese production, lighter and reusable containers for beer, mineral water, and main fresh vegetables, newer diesel-powered vans, less air-polluting electric ovens instead of traditional wood-fired ovens, as well as renewable electricity sources.