Where is the best place in San Francisco to get custom-designed business cards printed?

Oscar Printing does very high quality print jobs, with the opportunity for offset, letterpress, debossing, foil stamping, fancy paper, and other special print techniques. If you're looking to invest in a card that stands out, I can highly recommend them. For a cheaper card, you might want to look into places that just to regular digital printing — there are dozens of them.

I had a good experience with Clubcard (http://www.yelp.com/biz/cl-san-francisco), which used to be in the Castro but is now in North Beach. After PS Print in Oakland failed to ever get a prior complicated business card printed correctly (it had two rounded corners), I chose Clubcard because I had seen their sample pack at Pride many years ago. The pack contained many intricate designs, so I figured I could get someone at Clubcard to walk me through the process and get it right the first time, spot UV and all. Working with Clubcard was not without frustration. 1. They wouldn't give me a quote on the spot but had to get back to me a day later.  2. Every snag seemed to reset the counter on how long things would take -- even though I had visited in person for the express purpose of avoiding snags. 3. They forgot to notify me when my order was done. But they made it up to me by mailing the order to me at their cost, which was more convenient than getting them sooner but having to go in person. And you know what? The cards were perfect. The first time.

Autumn Express on 16th and mission made me some cards overnight. High quality, did a good job. They've also done flyer printing, etc for me.

After going down the path to which you aspire and now clicking my keyboard among boxes of my unused custom business cards for a variety of startups, I would be inclined to go completely away from anything close to a traditional business card.  If I weren't in a hurry and I wanted a high value business card that I could bestow upon the recipient - as opposed to indiscriminately handing out trade show style - I would move in this direction: http://www.brandingidentitydesign.com/25-clean-minimal-business-cards/. I particularly liked these: