It's fine, it's a tourist mcdonald's and as I'm sure it's wildly busy most of the time, they appear…read moreto have a slightly limited menu and basically no counter or "front." Instead it's all machine ordering and pickup at the kitchen side. I don't mind that part at all, it's perfectly fine and honestly I would go this route anyway.
I did have issues getting my order correct as I had to point out missing items on the receipt twice. While they easily fixed it for me, I saw them checking the receipt as they prepared my order and it was a little disappointing that they left out so much stuff. I ultimately still got shorted a small fry but at that point could not be bothered to argue about another thing and realistically we already had enough food anyway. Still, it was a big annoyance: I feel like in exchange for the "okay" food and experience of Mcdonald's, the least you should expect is that they can just put your order together pretty accurately. Especially considering the machine ordering and ticket based system they use, it's a big let down to have to triple check your order and argue with them about missing items. I can't imagine how much of a pain it would have been if it hadn't been a quieter day when I was there - 300 tourists jamming up the place would make trying to fix your order a real pain.
Food-wise, I feel the same about most global mcdonald's - it's fine but as the price continues to creep up it's no longer worth it and at this point it's very much no longer worth it. We continue to very occasionally visit simply because of children and often the lack of other fast food options (as in this case at Pisa). Given the cost of a meal for 5 was roughly the same as having gone any real restaurant, even at tourist prices, it's hard to justify except in these kinds of situations.