Clothing/Shoes/Weather Gear: Bring two pairs of walking shoes -- you'll do more walking in Rome than almost any other city you'll ever visit. Shoes that are comfy when visiting the mall may start causing problems after a day on Rome's streets. Switching between pairs can help.
Toiletries & Medical Supplies: Bring your own washcloth (facecloth) - even the best Italian hotels don't carry them. The Hilton at the airport has them, and other American chain hotels may have them, too. Pack a plastic bag to carry it back. I take one that I found at a Bed and Bath store. It is synthetic, so dries faster. Also, makeup rinses right off it! Amazing!
Miscellaneous: Bring a role of white athletic tape. It comes in handy, from sealing the mailing tube you buy to protect your antique print, to an emergency hem repair, to securing a bandaid that won't stay put. I've used it to hold down the "on" button on those annoying hair dryers some hotels have - you have to continually press down on the on button, or it turns off. I understand wanting to save on electricity, but geez, this is annoying!
Oh yes, and earplugs, especially if you've never stayed at your hotel before. There could be street noise - even with double-glazed windows. There could be noise from the hallway, the room next to you, etc.
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