I do, Postfix and Dovecot. Mine's got 10 years of history so I've been spared being blocked everywhere.

Most will tell you the software side is not too bad these days but the constant fighting to get your emails through can be really rough.

Personally I find it useful if only for the sake of just registering every service to its own unique email address so I can track who got my data where, and I get the privacy of Google not knowing every site I'm registered with. I still use my Gmail when I want to be sure it goes through.

I really don't send that many emails so it works pretty well for me.