For starters, I enjoy a great deal of preformance optimization. Granted, I never had issues as badly as others did, I have yet to lag in Freeside at the 4-way intersection, I've yet to lag at Forlorn Hope, and McCarran load times are MUCH more quicker. Secondly, I've seen a myriad of quests and side quests being able to be completed. I've also noticed explosives (mainly due to enemy fire) to be much more deadlier, with me getting crippled 5x more than ever before.
On to the gripes, I was in a grump I had to uninstall and reinstall New Vegas to get rid of the patch and wait until AFTER I dealt with Benny to reinstall the patch, for me personally, I had a quest break mildly where Swank won't remove the two sets of items you are supposed to show him. Secondly, the increase in weapon mod prices can be ridiculously high. I know it helps to keep the economy stable, but spending 1-3k on a single weapon mod is ludicrous.
I may have more to add to both camps when I complete this character, but as of now, I'd say the patch is definitely a hit/miss. Alot of Good, but some noticable bad.