Become a MacRumors Supporter for $50/year with no ads, ability to filter front page stories, and private forums.
I use it and have for about a year. For the most part it works well. The only real issues I have with it is that when my ISP has a bad day my phone acts up which isn't Vonage's fault. My 256kbps upload is not enough some days and people will say that I cut out or sound choppy, but I can hear them fine. I think this is because I have a 3Mbps download. I used to use it with 128kbs upload and 512kbps download and it still worked, I just had more "bad" days with it. When it works like it is supposed to, the sound quality is great. All in all, I would rate it's sound quality and reliability like a cell phone. Some days are great and others are horrid, but over all it is satisfactory. It does save me a bundle on my phone bills though.
 
Register on MacRumors! This sidebar will go away, and you'll see fewer ads.