The episode title is a reference to the Bravo reality TV series The Real Housewives of..., which is itself a play on the ABC comedy/drama/mystery series Desperate Housewives.
Fat Tony's niece and nephews are parodies of people from the reality TV show Jersey Shore. Vincent, "The Occurrence", is a parody of The Situation from Jersey Shore and Tushie is a parody of Snooki.
The last scene with a blazing New Jersey map is a parody of Bonanza famous intro.
When Bart and Lisa are at Luigi's restaurant we see Spiderpig (from "The Simpsons Movie") sharpening the knives.
It is heavily implied that Fat Tony may be from New Jersey as he and his family speak in Jersey accents and his vacation home resembles Jersey Shore.