In this video, I detail my method of converting Raster PDF's to CAD (DWG). This is not necessarily required if you have a vectorized PDF; that should go without saying.
A Raster PDF usually originates from a scanned document. Very old PDF files might need to be converted manually as well. Although there are countless 'Raster Converters' out there, I tried them out and was never able to achieve a satisfactory result. Additionally, trying to work with the result of a raster conversion wastes large amounts of time; linework will at best be slightly off. Text will be broken into individual line segments, among other things... it will basically save you a few hours at the start of a project but cost a multiplied amount of those savings by the time the project is complete.
I chose to manually convert the Raster Image. I speed the process up using some customization techniques. And I find ways to improve my workflow each go-around. I'm sure technology such as machine learning will eventually do this for us, but for now, I think that manually converting these files is still the best method.