It is a testament to Monte Cook's talent as a game designer that he is able to translate the World of Darkness into a workable d20 ruleset, especially considering how, well, BAD the superficially similar translations of Aeon/Trinity, Aberrant, and Adventure! to the d20 rules turned out. Equally wise on Cook's part is the choice to jettison the myriad and at times Byzantine (not to mention conflicting) metaplots the World of Darkness product line is known for.
That said, to say Monte Cook's World of Darkness has complicated rules is to strain "complicated" to its utmost limits. Keeping track of the names for each character's special abilities is hard enough, much less determining what, exactly, those abilities DO. Do NOT start a "MCWoD" campaign above first level unless you have supreme confidence in your ability to crunch numbers, keep track of figures, and memorize charts.
Stylistically, the book at times feels as though it's reaching too far for the "edgy" descriptor--which may itself be a commentary on the Old World of Darkness books' zeal in using first-person narration, but I'm probably overthinking that--but manages to get the point across that this World of Darkness really is not a nice place.
All things considered, this is a solid (well, relatively solid, this being a .pdf file) book, but I cannot recommend it for anyone who is not a fan of Monte Cook and the bloodier side of the World of Darkness (which includes the Vampire, Werewolf, Demon, and Mage books; Changeling fans are sadly left out).