This has always been possible, going via LaTeX.
However, LaTeX being what it is, you either need to learn it, or you end up with rather plain-looking documents.
While that's ok for a manual, I want to use Restructured Text for everything involving documents.
So, I looked for another solution. Sadly, I could not make the existing rlpdf writer work, sooooo I decided to write my own tool.
Since I intensely dislike the Visitor pattern involved in writing a regular docutils writer, I adapted my old rst2rst.py and ended with rst2pdf.py which just traverses the tree recursively and writes the PDF using ReportLab.
And it took me about 3 hours to make it work:
For a limited subset of RST (no footnotes, no links, no decoration)
For some subset of tables (no col/row spanning)
With limited "styling" (it's mostly there, but I need to write a lot of ReportLab styles.
How well does it work... rather well.
Ignore aesthetics, and consider function, it's pretty good.