A. Nystrom explores the influence Sicilian immigrants have had on New Orleans foodways. His culinary journey follows these immigrants from their first impressions on Louisiana food culture in the mid-1830s and along their path until the 1970s. Each chapter touches on events that involved Sicilian immigrants and the relevancy of their lives and impact on New Orleans. Sicilian immigrants cut sugarcane, sold groceries, ran truck farms, operated bars and restaurants, and manufactured pasta. Citing these cultural confluences, Nystrom posits that the significance of Sicilian influence on New Orleans foodways traditionally has been undervalued and instead should be included, along with African, French, and Spanish cuisine, in the broad definition of "creole."

Creole Italian chronicles how the business of food, broadly conceived, dictated the reasoning, means, and outcomes for a large portion of the nearly forty thousand Sicilian immigrants who entered America through the port of New Orleans in the nineteenth and early-twentieth centuries and how their actions and those of their descendants helped shape the food town we know today.