I need an extra pillow.
cu-SCI-no — three syllables, stress on the second. 'sc' before 'i' = 'sh'.
A simple request that reception will fulfil immediately, usually within minutes.
'Ho bisogno di' + noun is the standard Italian expression for 'I need'. 'Cuscino' = pillow. 'Extra' is used in Italian just as in English. Pillow comfort is personal — do not hesitate to ask for more or different pillows.
Ho bisogno di un cuscino più sodo.
I need a firmer pillow.
Specify firmness preference
Posso avere un cuscino in più?
Can I have one more pillow?
Alternative request using 'in più' (more/extra)
I cuscini sono troppo morbidi.
The pillows are too soft.
Describe the problem so staff bring an appropriate alternative
Italian hotels traditionally provide one pillow per person in a standard room. Northern European and American guests often want more. Do not hesitate to ask — extra pillows are always available. Some high-end hotels offer a 'pillow menu' with different fillings and firmnesses.