I'm pretty stoked, myself. I'm looking forward to messing around with the character customization - I wasn't really a fan of the sliders system (even if it did give a lot of options,) so I'm anxious to give the new system a try. Animations look to have improved a bit, too - I still feel like that's not Bethesda's strong suit, but what I saw looked more natural at least.
Personally, I think I can get behind the spoken dialog for the PC. I enjoyed it in other RPGs (Mass Effect, etc,) and am hopeful it might help inject some more personality into my "blank slate" representation of my character in the game. At the same time, I'm sure that's a hard sell for a lot of Bethesda fans - I foresee a lot of talk about this aspect for some time to come, I'm sure.
While the basic setup appears to offer 4 dialog choices at a time, Mass Effect specifically would commonly get around this limitation by assigning one of the options as a sort of cascade option, opening up to offer more options. If Bioware figured out this trick to allow more than four choices for certain dialog branches years ago, I'm not too worried about Bethesda's first go at this. In practice, I've found in other games that take this approach that I didn't often feel any more limited than I otherwise would have, and many dialogs in Fallout 3 didn't offer more than four responses anyway - and as I said you could simply assign one button as a "more" option as needed...
I think what's going to really turn people off about the voiced PC dialog is simply having a character that may not sound like what you'd intended for your character.
Other than that, I'm pretty excited to see this thing in action. To me, it's looks like a very pretty game from what I can make out. Hopefully they've tweaked the ruleset a bit for issues I've had with it since Fallout 3, but at the very least it looks like it's going to be a fun game.