I tried PinPoint for a few days, and was finding it somewhat useful with my dual 30-inch monitors, but what convinced me was when I fired up Photoshop and was retouching a photo that was mostly gray asphalt. Adobe still hasn't given us the option of changing the cursor to a colour other than gray, so here I was struggling to find the healing brush when I remembered that I installed the PinPoint trial. I activated PinPoint (I have it off most of the time), and was able to see the cursor no matter what the background.
Things I like about PinPoint include a wide range of different cursor styles and the ability to tweak the appearance of the cursor, a hotkey option to toggle PinPoint on and off (which is how I use it), and the option of hiding the menubar icon. I have fund that occasionally it doesn't toggle on or off properly, but an extra press of the hotkey usually fixes that.
What I would like to see is a monochrome menubar option (the red icon bugs me), and a "Toggle" command in the menu that drops down when the menubar icon is clicked (for those times when it's awkward to use the keyboard hotkey combination, or for when the hotkey doesn't properly toggle the cursor).