I have been a huge fan of Provisioning Server ever since I started working with it when Citrix acquired Ardence a few years ago. It is arguably indispensible in medium to large XenApp environments and provides the mechanism around efficient management of images for XenDesktop. That being said I think a lot of organizations are turned off to using this technology based on the perception that it is overly complex.
Probably the 2 main reasons for this perceived complexity is the need for hardware commonality and the image upgrade process for specific items such as the PVS client, NIC driver, and certain other specific scenarios. It is true that when streaming an image to bare metal the hardware needs to be relatively common, i.e. the same, across all systems consuming said image. However, there are ways to layer in flexibility via a common image build process. The second challenge around upgrading vDisk images has also recently been addressed with the release of Provisioning Server 5.1.
Prior to PVS 5.1 upgrading items in the image such as the PVS client or NIC drivers meant you had to lay your image back down to the physical or virtual machine from which it was captured via a reverse image process, upgrade the software or drivers, and then capture your image to a vDisk once again. This process is time consuming especially if your a large environment and have many different vDisks. Trevor Mansell, an engineer at Citrix, recently posted 2 great articles on how to leverage the new functionality called Direct VHD Boot in PVS 5.1 to enable the boot of even hardware based vDisk images on Hyper-V or XenServer eliminating the need for the reverse image process and recapture.
http://community.citrix.com/blogs/citrite/trevorm/2009/08/15/PVS+5.1+Direct+VHD+Boot+using+XenServer
This functionality adds a tremendous amount of efficiency to the vDisk upgrade process as well as many other benefits to XenDesktop environments, and physical and virtual environments where PVS is leveraged to centrally manage the delivery of operating systems. Thanks to Trevor for this great information!
Matt Hensley's Blog 
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