[5] O'Keefe has a keen interest in fine Italian wine made from autochthonous grape varieties.

[5] She has been acknowledged to be "one of the great wine commentators on Italy"[6] and "a critic in the best sense of the word, not shy with her opinions, which she offers without polemics or bluster.

[26] The Brunellopoli scandal was not a surprise for O'Keefe,[5][15] as she had been questioning Brunellos which were suspiciously dark and without the typical aromas of pure Sangiovese wines for years.

[9] O'Keefe opposes the view held by many about the so-called American Palate, or the preference for highly oaked, sweet and powerful wines.

[31] O'Keefe has also been critical of the tendency of some Italian wine producers to "equate what they call un vino importante with overwhelming sensations of French oak.