We have eaten at Montesano's a few times, but always from their pasta menu and never the pizza. So with that in mind...the review. There is no shortage of Italian restaurants anywhere in LV/Henderson and the styles and flavors are endless. And like most food, everyone has their favorite, and their 5-star pick may be someone elses 2 star. Such is food, particularly ethnic food. Heck, we have even been to Italy for a few weeks and considered that to be some of the worst Italian food we had ever had...so go figure. Anyway, the food that we have had here is pretty damn good. Maybe not the 'best I have had anywhere', but very good nonetheless. The last time there, had the Spag and meatballs. The balls were huge and plenty of pasta, although the sauce was a little light, but they happily brought more. My wife went for the raviolis with a different sauce than mine, and it was great too. The restaurant was very casual, which is exactly how I like it. Don't shove tablecloths-candles-etc in front of me---I am there to eat. And that is what I did, and we willl be back.