I had problem of stuttering like loading ingame and frame pacing all over the place unplayable for me.

Here the solution:

install widescreen fix (link in the sticky topic)

game settings:

- 1920x1080 antialiasing 4x
- uncheck full screen to run the game in borderless window mode (it solves the frame pacing and have consistent fps in any situation)

enabled: texture true color - lights true color - audio disable eax - advanced transform and lighting

all the other option disabled

in the end to solve the loading ingame stuttering you have to go to task manager (when ingame you have to push windows button then go with mouse on the windows bar, right click and task manager), right click on mafia 32 bit, then go to details, right click on mafia.exe --> affinity --> disable all cores and enable only core 0 (you have to do this every time you run the game)

now the game is rock solid and it's perfect

I do nothing if this. And do not have any problems. Of course except wrong camera POV on widescreen resolution, but im OK with that.
Also, it possible to enable EAX on any sound cards, so i didnt tuen off EAX sound in configurator. Creative Alchemy work. Instead of installing whole program, i guess google can provide Creative version of dsound.dll+dsound.ini files - that only need for EAX in games. This is the only one that i download, but not any fixes specific for that game.

For widescreen there is own ini-file. Some of this settings can result CTD (on some machines?). At least, do not modify if it works as is with default settings.

ENB or ReShade work great too, except motionblur.