Trenitalia Frecce operates a train from Pisa to Alessandria Station twice daily. Tickets cost $30 - $50 and the journey takes 2 h 46 min. Alternatively, VaiBus operates a bus from Pisa to Alessandria Station hourly. Tickets cost $3 - $4 and the journey takes 50 min. 2 other operators also service this route.
From Pisa Centrale train to Alessandria. 2 h 46 min 32€. From Pisa Centrale train to Genova Piazza Principe then train to Alessandria. 3 h 35 min 33€. From Via Crispi 93/95 bus to V. Emanuele Ii 2, bus to Lucca, then bus to Alessandria. 6 h 5 min 25€. From Pisa drive to Alessandria Station. 2 h 35 min 37€.