A piece of history, that needs some surgery for the price
The Mark Hopkins is an ageing beauty, but perhaps its time for some reconstructive surgery.
Upon arrival, you really do get a sense you're staying in a piece of history. The grand entrance and the even grander address (number 1 Nob Hill) is breath taking, and the view over San Fran from our 10th story room was amazing. The lobby, check-in desk and even the hallways all look like you've walked into the 1920s. The pictures on the walls from when the Top of the Mark (the top story viewing bar) opened and people would cue for hours to go up, give a sense of the hotel's past. 
However in terms of the hotel's present, things could be tightened. The rooms are standard size - certainly not luxury - but they are clean and crisp. In our room, the wallpaper was lifting off in the bathroom and the shower head leaked everywhere (we reported it…the promised "engineer" never did turn up). The bed had obviously seen better days, so they had lined it with a removable mattress layer, but unfortunately it would slip every time you moved, so by the end of the night it was on the floor.
In saying that, the housekeeping services are exceptional, coming twice a day. Everything, everywhere in the hotel was spotless.
The WIFI internet service is absolutely TERRIBLE. It's slow and it just can't cope with modern devices like iPhones and iPads. I couldn't work out what was going wrong - I suspect once you connected your phone, it kicked your computer and iPad off and vice versa. I rang the Concierge for help but they weren't exactly computer literate, so the mystery was never solved. 
You get a sense everything is geared for you to rack up a big bill (you even get a key to the bar fridge, presumably to protect the outrageously priced $6.50 bottles of Evian). I'm an InterCon Ambassador member and all you got was free WIFI (a saving on the ridiculous $16.50 daily fee for a service that didn't really work) and bottled water, plus the room upgrade. The 4PM checkout that came with Ambassador membership was welcome though.
In terms of location, there is nothing immediately around the hotel - not even a cafe to get a morning coffee. It was a good 20 min walk to a decent cafe, a 5 min walk to a convenience store, 25 min walk to Union Square, and 40 mins to Fisherman's Wharf. Chinatown is your closest district (10 min walk). However, remembering this is San Fran, walks are really hikes (hills!!), but I didn't mind seeing the city by foot. The famous San Fran trolley (tram) is right out front, HOWEVER it is the tourist route so its $6.50 one way - so it's not meant for day to day transport. It was a $20 cab to places like The Mission or The Castro.
I think the Mark Hopkins needs to decide if it is a mid level or luxury hotel. If its luxury, the room amenities really need to step up (new beds, fix the bathroom fixtures) and things like WIFI should be free / top-notch reliable. If they want to position the Mark Hopkins as a mid-priced hotel, the room prices need to come down to match the state the rooms are currently in.
Would I stay there again? Probably not - but not because the experience was terrible, but for the price I think I'd prefer to be closer to the action in The Mission or Castro. 
However if you're after more of a day holiday (don't need night time bars / clubs / restaurants) and you like the idea of connecting to San Fran's history, you'd love the Mark Hopkins. Even if you stay somewhere else, Top of the Mark is open to the public and worth a visit to connect with the old San Fran.