We have had Pictometry fly our county twice in the past 3 years and the imagery is used heavily thoughout our county and now several cities within our county are using it as well. It has become a must have and we will likely continue to fly it every 2 years, and possibly go to annual flights at some point.
The Pictometry software reads GIS data directly from our ArcSDE database, so it integrates well there. We also have their ArcGIS Extension which allows you to use the obliques in ArcView. This has been useful in identifying features that cannot be seen in an ortho. We don't use AutoCAD, so I can't comment on that.
As for accuracy, that was a concern of ours at first, but they processed the data with our LiDAR and our GIS data overlays perfectly on the obliques. We tested the accuracy of the orthos that are delivered with the obliques and they were identical to the imagery from our previous ortho vendor, however the Pictometry imagery is much clearer and the colors are more realistic. All in all it has been a good investment for our county.