Yes, it is really NECESSARY, unless you just want to stay in Sarteano the whole time. Tuscany is one of the regions least well served by trains; buses generally operate from villages to the closest larger town, to take children to school in the morning and bring them back in the early afternoon; there are no taxis in Tuscan villages.
You don't HAVE to rent a car but I think you'll enjoy Tuscany more. Otherwise you are dependent on the bus and train schedules. The fun and freedom of driving through Tuscany, in my opinion, is what it's all about. Many of the towns have very poor or virtually no access to trains without driving for a while.
This is a fantastic trip of a lifetime from the way it sounds so why limit yourself because of a few extra dollars. I think you'll be glad you rented a car.
I stayed in Sarteano for 10 days. You will definately want a car. If you are staying in the storico district you will have to park your car in a lot near the city center. I was too afraid to take it to the house, as the streets were skinny and there were hairpin turns that were not made for cars. Chiusi is about 10 mins and there is a train station and taxis. It is easy to drive in this region, in fact it was fun! The people in this town are wonderful, enjoy your stay...
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