The good, is you get a clean picture without all the unsightly tearing and shearing, which IMO subtracts significantly from the visuals
The downside is if your graphics card is not fast enough to generate frames at the rate your monitor refreshes, your framerate can drop more than in non v sync mode due to the fact the screen will only update when the whole frame is drawn
Personally i always leave it on, glitchy graphics are very unsightly, go to the nvidia control panel i think it's manage 3d settings, set it on from there, or do it from the game