Pistoia occupies a specific position in Tuscan tourism geography that is entirely determined by its location: 35 minutes by train from Florence (which means that every tourist who visits Pistoia is mentally calibrating against Florence) and 45 minutes from Lucca (which means the visitors who make it to Lucca frequently don't continue the extra 15 minutes to Pistoia). The consequence: Pistoia remains genuinely local in character despite being within easy reach of two of Italy's most visited cities. The outdoor plant nursery industry that dominates the Pistoia plain (Pistoia is the largest ornamental plant production center in Europe, supplying parks, gardens, and urban landscaping throughout the EU, a fact that appears on no tourist signboard but explains the specific green-and-growing character of the city's agricultural surroundings) keeps the local economy grounded in something other than tourism, and the specific result is a medieval Tuscan city center that functions as a city center rather than as a museum.
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What to See in Pistoia
The Cathedral of San Zeno and the Silver Altar
The Duomo di San Zeno (the Cathedral of Saint Zenobius, Pistoia's patron saint, not the same Zenobius as the Florentine saint, which is a specific Pistoiese point of distinction from their much-larger neighbor) has the most remarkable single liturgical art object in Tuscany after the Baptistery doors: the Dossale di San Iacopo (the Silver Altar of Saint James), a silver altarpiece begun in 1287 and worked on by every major Tuscan goldsmiths' workshop for the following two centuries, including Brunelleschi himself, who contributed two of the side figures in 1400. The altar contains 628 silver figures in total and represents the most complete surviving example of Gothic and early Renaissance silversmithing in Italy. It is kept in the Chapel of San Jacopo and requires a separate ticket (approximately €3). It is almost never crowded.
Ospedale del Ceppo: The Glazed Terracotta Frieze
The Ospedale del Ceppo (the historic hospital of Pistoia, founded 1277 and in operation as a hospital until 2013) has on its loggia facade a frieze of glazed polychrome terracotta tiles by Giovanni della Robbia (completed 1525-1530) depicting the Seven Works of Mercy, feeding the hungry, giving drink to the thirsty, clothing the naked, sheltering the traveler, visiting the sick, ransoming the captive, and burying the dead. The frieze is the most complete and best-preserved of the della Robbia family's narrative terracotta programs in Italy and the most accessible (visible from the street, no entry required for the exterior frieze). The hospital building is now the Museo del Novecento e del Contemporaneo di Pistoia.
Pistoia Blues: The Jazz Festival
The Pistoia Blues festival (held annually in July in Piazza Duomo, in front of the Romanesque cathedral, one of the most atmospherically specific outdoor music settings in Italy) has operated since 1980 and has hosted B.B. King, Ray Charles, Eric Clapton, Van Morrison, Herbie Hancock, and virtually every significant blues and jazz name of the past four decades. The festival is ticketed (pistoiablues.com) and represents the specific Pistoiese cultural investment in music that distinguishes this city from the generic Tuscany tourism circuit.
Q&A: Pistoia
Is Pistoia worth visiting if I'm already seeing Florence and Lucca?
Yes, specifically because it isn't Florence and Lucca. The specific Pistoia value for the visitor who has already covered the canonical Tuscan cities: the Silver Altar (genuinely not seen in any other context in Italy), the della Robbia frieze (the most accessible and least touristed of the major della Robbia programs), and the specific quality of a Tuscan city center in which the ratio of tourists to residents is inverted from the Florence norm. A half-day in Pistoia from either Florence or Lucca by regional train produces a complete experience of the medieval city without requiring accommodation.
