We will be visiting Italy for 10 days. 3-4 days in Positano followed by 4-5 days in Sicily.
Then back to Rome for 2 days and home.
What area is the best to stay in Sicily for the most sights to see. if you were to
start in Palermo, how long would you stay there (and what is the very best hotel) and what other areas of Sicily would be high priority to see/stay.
What is in Ragusa?
We are looking to stay in best accomodations available- 5 star when possible.
We plan to hire a guide during some of the days.
Any suggestions are welcome.

If you are in Positano you might want to just do the eastern side of Sicily which is fabulous. How are you getting to Sicily? Train,ferry or plane? If you are doing the eastern side then I would just do Taormina as a base and Ortigia(which is the old section of Siracusa south of Catania) that is magical.I really don't think that you need a guide in Sicily-just some good guidebooks.
If you have 4-5 days, then remember that you will spend part of that time traveling to and from.

to dutyfree:

Thanks for the suggestion. Would you skip palermo altogether?
I actually do not know how to get to Sicily yet. It will be the first week in april.
Do you know what the options are at that time of year?
I had assumed i would fly from Naples but do you have another suggestion?

I have only flown to Sicily from Milan and Rome and that was Catania. I think that you are going to find that that Easter week is going to be difficult for traveling as things will be closed;flights and ferries packed and schedules are changed.

Have you done Rome thoroughly-maybe a daytrip to Ostia Antica or Orvieto thrown in? I think that you are being way too ambitious for Easter week and adding in Sicily if you only have a few days.Sicily is wonderful but you really need more time to do it justice IMO

We did Rome and Florence a few years ago and did all the things you mentioned.
We have also been to Venice so it seemed the Amalfi Coast and Sicily would be great to see.
We are only going back to Rome because we need to fly back to Chicago from there.
We can probably easily spend 5 days in Sicily or possibly 6 if it makes sense.
Knowing that, do you have any other suggestions of where to go in Sicily. Is it worth being in Palermo and taking a few day trips from there?
Can Mt. Etna be visited easier from Palermo or Taormina?
Appreciate the advice.

I think it is much easier to visit Mt, Etna from Taormina. I loved Castelmola which is set up high in the hills near Taormina. Palermo is a really ugly city, very crowded with lots of traffic. I know there are some famous churches and architecture there but overall it is not pretty! We really enjoyed Erice, a beautifully preserved medieval town set up high in the hills and the perfectly preserved Roman site, Segesta, about a half hour away. The roads are easy to navigate once you're out of a big city like Palermo. There just aren't that many of them. They mostly circumnavigate the island. We rented a car and had no trouble, although we got really lost trying to find the autostrada in Palermo. The traffic and signage was terrible.

We spent 6 days in Sicily in Fall 08 and focused on eastern Sicily and had more than enough to do. Definately don't miss Agrigento-the Greek ruins are fabulous-allegedly better than those is Greece and there are little to no crowds to speak of. Catania or Taormina are good possible bases for eastern Sicily. From there you could see Siracusa, which also has well-preserved ruins and catacombs, along with other sites worth seeing. Mt. Etna is also an easy drive from those places. If you like hand painted pottery, Caltigarone is worth a few hours, just for the amazing tiled stairs and pistachio pesto! There is also a ruin of a Roman emperors hunting lodge not to far from Caltigarone which has amazingly preserved mosaics and is in a pretty setting. We ended up flying out of Palermo, which was not part of our original plan. We spent one night there is a really nice boutique hotel. We were glad to see Palermo but only spend 24 hours there so can't really speak to it. I must admit that I found it to have a certain almost sinister type feeling in some spots that I've only noticed in Naples before. Wasn't my favorite place in Sicily but I was definately glad we visited.

The eastern side with Mt. Etna,Taormina,Siracusa (Ortigia)with possible trips to Ragusa,Agrigento,etc. will definitely fill 5-6 days.
My daughter spent a semester in Ortigia in college and loves the western side but did so many trips on the eastern side that she enjoyed. If you only have a limited amount of time you may have to chose?

You might have more in common with the writer of this (very long and detailed) trip report on six days in Sicily than with the vast majority of Fodorites:
http://www.tripadvisor.com/ShowTopic...ly-Sicily.html