I love my FIOS, except for one notable exception (which I'll explain). The service works identically to Comcast, with the simple difference being a new line coming in to the house, going to a new control panel. When I had mine done, the tech did not run any new coax, he just swapped out the Comcast boxes for Verizon ones. I believe they even used the same Motorola model.
FIOS means nothing to your television, so there's no upgrade needed - if the TV can accept a signal from the cable box, you're fine.

The notable exception is their DVR service, in particular the "home sharing" thing (which allows you to watch programs on any tv), is incredibly disappointing to the point where I'm looking at my other options. To get that feature you need a single "hub" unit, which does all the DVR functions. Any other tv in the house is just a player. What's that mean? Among other things, you can't start a recording from any other TV but the main one. Nor can you delete shows, so if you do watch a program through to completion in another room, it'll hang out taking up space until you remember to delete it from the main one. When streaming a show between boxes like that, I find the skip forward/back buttons work so badly I don't even bother.

Even without the sharing bit, the DVR functionality is still very weak compared to Tivo, and honestly even compared to Comcast. I love for instance when you record something but there's already two shows planned - it simply says "Conflict", and then tells you the two shows that were already scheduled. Apparently you have to pick one...but pick one to what? Pick one to keep, or one to cancel? It doesn't tell you!

Hope that helps. I'm also a little disappointed in the number of HD channels on FIOS - it seems like several times the DVR has tried to record something because it thinks I have that channel, but then I discover that I don't, even though I have the standard def version of the same channel.
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You will need a box for every TV that doesn't have a clear QAM tuner. Many new TVs have them, but most older than 3 years won't. These can be rented from Verizon for $3.99/mo.

The quality is some of the best in the industry as Verizon has chosen to spend money on throughput and not reduce the signal quality in order to make up for not having enough bandwidth for all the services they want to provide.

The reliability is also great, but the same can't be said for the customer service. Verizon is notoriously bad at customer service and billing issues. If you already have Verizon's Internet access then you may already know what I mean. Luckily most don't have problems, and do eventually get the problems resolved.

If you have an HDTV -- highly recommended -- then FiOS is a fantastic provider as they offer as many national HD channels as any other provider at over 100.

They also offer a lot of free VOD programming if you rent a box that supports it (the $4 box does not).
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