Does an excellent job of what it sets out to, which is tell you a story with you as the main character.
The atmosphere of the game is where it really shines. The Source engine obviously allows for excellent eye candy, but the work of the artists comes to play throughout, as the gritty underground Vampire: The Masquerade world really comes to life.
The game does as good a job as any I have played at forcing you to really feel like you are in an alien world, which you are as you play a fledgling vampire. You are never quite sure who to trust, what NPC motives are, and the layers of the vampire world peel back to always reveal darker and more sinister developments. Throughout the game you never really feel as if you are in control of events - you are clearly a pawn of other forces. This makes the game very compelling as the perspective of your PC is supposed to be that of a rookie or fledgling vampire, thrust into a hidden world that is hidden from mortals.
The NPC characters are well fleshed out and fun to interract with. The game doesn't pretend to be fully open ended (although the character development is), and this allows NPCs to be much more fully realized as per the authors' vision. I personally appreciate this very much, as it reminds me somewhat of Planescape: Torment in the way the game feels more like a novel that you are playing through than a game.
I say it's a mustplay for RPG fans, particularly since it can be bought cheaply in stores or even downloaded from Direct2Drive.