I have it working with Vista64, although I'm getting intermittent audio issues.
If you have a dual core chip, you have to set processor affinity to a single core. The easy (but non-permanent) way to do this is to start the game up as far as the main menu, ctrl-alt-del out and look for sshock2.exe (or something similar) under the processes tab, and set it to a single cpu core.
Unfortunately you might also have trouble depending on your video drivers, I'm using the latest ati ones on an x1800xt.