Consider this your freebie spoon feed. From now on out, the FAQ are your friends.
To answer the initial question, "Is it worth it" the answer is "Hell yes."
I see reliability and wants as different entities. Apples and Oranges.
Wants: Yes, and more. GPS, All your
Music, VGA quality
video, SNES/NES/N64 emulators, Ability to skin (or change the appearance of) your frontend (application that makes everything touchscreen friendly and look more like a HU than a computer) on the fly, greatest control over
sound outputs through all the different equalizers and other such goodies, das interwebs, phone control, sat
radio, FM radio, and the most important "Cool factor"

.
Reliability: Good enough for me. Here it is bluntly though. How good are you at computers? Like if for some reason your computer doesn't boot what do
you do? Do you open it up, and see what is amiss, or call Dell? If you are the latter, then the initial setup of a PC may be too overwhelming or frustrating. Not to say it cannot be done, but you will have many a frantic nights screaming and yelling and waking your neighbours as to why you have no sound or why your car wont boot! There are prebuilt units such as the mac-mini and the aopen models (that are still less than the pioneer unit) that come with a warranty and tech support. Obviously it is more expensive than buying the components and assembling/troublshooting yourself.
Reliability #2: Computers will crash/hang/freeze/self destruct/launch your car into space... well maybe not the latter, but these things are inevitable. Now the frequency these things happen is greatly based on your install. A HU is a "plug-n-chug" device. You buy, you plop it in, you go. A computer is buy, take a while figuring it out and the best way to install, install, get angry at why something doesn't work, fix it, try again, go. I have had 2 BSOD (Blue Screen Of Death's) in my car over the past year. The fix you ask? Push reboot, wait 20 seconds and done. I also had a freezing issue due to the crap HD. The fix i hear you cry? Temporary: reboot and music in 20 second. Permanent: Wipe it with a fresh install and put it back in. Took about 4hrs including the XP install over a USB drive.
How much do you want: The CarPC is still a small market. Is AM radio important to you? I hope you said no, because you cant get it with a CarPC. Sorry, but that is just how it is. You can however get FM with the HQCT (High Quality Car Tuner available in the store). Those USB modules are cheap and for a reason. They are crap. I have remote start and am now in the habit of starting my car when I see it with the remote. When I get there music is playing and usually 1 lady with the puzzled, "Did you just start your car?". "No lady, it is being robbed by the invisible gremlins!!!"

Usually my boot times were between 20s and 30s from ignition to music. Some people cannot get their system optimized for some reason and it might be as long as a minute. Now that is a cold boot. Meaning from no
power to on. There is standby which I use as well which is 2-3 seconds from ignintion to music. The automotive
supplies allow you to set the time to keep the system in standby before they "pull the plug" and you must do a cold reboot. There is also hibernate which varies by how much RAM you have installed, but on my via board with 1Gb of RAM, it took longer to go into hibernate and come out then to shutdown and cold reboot. Funny how Microsoft works isn't it?
Good = Opinion word
I use
onboard sound and am as happy as can be. Some people are audiophiles which you might be and you might want to look into DAC's and USB soundcards, or good (like the xFi) soundcards. To give you an example of the SQ a computer can achieve, look at Red's profile (full name: RedGtivr6). She (Yup, da ladies) is a world class sound champion.
Then do it... The only reason for both is for people who don't want another amp for their speakers and/or want easier control over their equalizer and/or want AM radio and/or don't know any better and/or lazy.
Always draws eyes when you start your car and the infamous
windows login chime goes through your speakers. A crowd of "Whaaaa?" follows.
All your music with no limit on storage.
Upgradeable to... well anything.
In the end comes out much much cheaper than an all-in-one unit with less than the above functionality.
You become an 31337 h4x0r!!!!! j/k.
<jarr jarr> Yousa Welcomes!</jarr jarr>
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