Have a family city break in Florence in the north of the region, once the heart of the Renaissance and still an awesomely lovely city with an unrivalled collection of art and architecture. Too many people, too many touts, and too much unrelieved history make it a place where you need to take it easy with children. The best things to do in Florence with kids are a trip down the Arno, an extended gelato stop, a stroke of Il Porcellino (a bronze fountain of a boar), a carousel ride or three, and a run around the Boboli Gardens with their statues, ponds, fountains and grottoes. With older kids and teens in Florence, be more adventurous: take in the Uffizi with its Botticellis, Michelangelos and Leonardos and the Museo di Leonardo da Vinci with its working machines, venture up the Duomo for its awesome city views, and check out the Museo Galileo science museum.
Go green about 11km outside Florence, in the Parco Pratolino (Park di Villa Demidoff), with a vast statue of the Colossus of the Apennines by Giambologna, a lovely chapel, a Cupid's grotto, fountains, an aviary, and wildlife deer, foxes and hares to spot amidst the vegetation.
Travel west for a gander at the Leaning Tower of Pisa in the city's truly miraculous Campo de Miracoli – it's a genuine marvel that no amount of photos can prepare you for (you have to be eight or up to climb it; to do so in high season, you also need to book well in advance). The other must-see is the Cantiere delle Navi Antiche di Pisa, where you can watch excavation work on 11 Roman shipwrecks discovered in marshland once occupied by Pisa's harbour. If you're in Pisa at lunchtime, buy takeaway pizza slices or panini from one of the modest bars on Via Roma and head to the botanical gardens for a picnic.
From Pisa, take a boat-trip into the Parco Naturale Migliarino San Rossore Massaciuccoli, with its impressive wildlife, birdwatching trails around Lake Massaciuccoli itself, cycling and horse-riding.
Discover Lucca just northeast of Pisa. It's the only town in Italy still fully surrounded by its walls, dating from the Renaissance. You can bicycle along these tree-lined walls – hire outlets have adult-child tandems, trailers and baby seats. Another highlight is the mummified body of St Zita in its glass shrine in the Basilica di San Frediano, but if you don't go inside, have a look at the extraordinary golden 13th-century mosaic on the façade, perhaps from the terrace of friendly Bar San Frediano, where you might be given a free panino with your drinks. Another scenic sight is the Piazza Anfiteatro, an oval-shaped piazza by virtue of the fact that its medieval houses were built within the remains of a Roman amphitheatre.
Head for the Versilian Coast, also north of Pisa, with its large beaches and shallow waters perfect for younger kids, plus medieval Pietrasanta with its marble and bronze monuments and workshops with live demonstrations. The best seaside resort here is Viareggio, where, for a moderate sum you can stake out your space for the day on one of the private stretches of Mediterranean beach, some of which have play equipment and small seawater swimming pools. The sea isn't the cleanest, but the setting – a backdrop of mountains behind a seafront of beautiful Belle Epoque buildings – is sublime.
Try hiking, caving, horse-riding and other outdoor activities in those mountains, the Apuan Alps, which run parallel to the coast. The Parco Avventura Fosdinovo here offers treetop circuits, mountain-biking and quad-biking, or from December to March you can even ski, at Abetone. The Alps information centre, the Centro Visite Parco Alpi Apuane, is in Castelnuovo di Garfagnana. The Garfagnana region itself, adjoining the Alps to the east, is wild, wooded and full of wiggling hillside roads, its chestnut forests roamed by wild boars, porcupines and the like. Apart from food (yes, you can eat the porcupine as well as boar), the highlights are the Grotta del Vento (Wind Cave) formations, and the donkey-backed Ponte del Diavolo near Borgo a Mozzano, named for a legend that has it that Satan himself intervened to finish its difficult construction.
Loop back down towards Florence. If you like animal parks, Pistoia Zoo is highly regarded and includes summer nocturnal visits to see animals that aren't very lively during the daytime. Also near Pistoia (but heading back towards Lucca) is the Parco di Pinocchio, a slightly faded attraction with bronze statues of characters from the classic tale by Carlo Lorenzini, set within a maze, plus a mechanical puppet theatre, live shows, weekend face painting and other oddball fun.
West of Florence, stop off to see hilltop San Gimignano, which evokes the spirit of life in the Middle Ages more than any other Tuscan site, with its thrilling skyline – often described as a 'medieval Manhattan' – of medieval towers. In high season it can be spoilt by crowds.
Go further west still, to the Tuscan coast sweeping down from Livorno to the Maremma, which is popular with Italians – especially the 150km of white beaches and clear water of the beautiful island of Elba. Though package tourism has well and truly found this little gem, it's a great place from which to go island-hopping, or you can ride the cable car up to Mont Capanne for stunning views of Tuscany and its Mediterranean coast. Never ever come to Elba in late July or August (May and Sept are glorious, on the other hand).
Otherwise, explore the big draw of this coast, the Parco Regionale della Maremma, with its deserted beaches amidst a landscape of pine trees. The birdlife here is spectacular, and there are walking trails, bike hire, horse-riding and canoeing trips.
Venture to the biggest attraction inland from here, amidst the idyllic rolling hills and vineyards of central Tuscany: Siena, the stunning medieval town best known for its bareback horserace, the Palio, held on two days in July and August. The event can be challenging for those with children, as there's lots of standing about in crowds in the heat, but a family themed tour with award-winning Context Travel, with the option of a stable visit, can make it more a more child-friendly experience. (Context also run family walks in Florence.)