We have a Roku HD and I'm considering this as a 2nd for the bedroom. We also have Tivo and playon. Happily dropped cable years ago.
Roku is a convenience for us--we -could- get the content other ways (we have a lot of options). The big plus for us is:
1. Amazon prime movies. Roku supports them, Tivo doesn't (Tivo only works with "normal" Amazon purchased movies that download to your tivo box--nice, but different than Prime).
2. Support for Playon. That lets us stream content that Playon supports--another thing you can't do with a Tivo. That's mainly for the Colbert Report/Daily Show streams--the one thing I do miss from Cable-days. Playon basically extends the amount of viewable content on the web in an easy format. Strongly recommended.
3. It's cheap and easy to get the same streaming content on multiple tvs with a consistent interface. For $50.00 or so for each tv, I have the same navigation and streaming content rather than using whatever happens to be connected at each tv and training the non-tech savy how to work each.
Yeah, number 1 and 2 of the above can be done with a Xbox 360 or playstation or various other devices. The price, extreme ease of setup and navigation, and tons of official and hidden additional Roku "channels" (like Ted Talks, Hulu Plus, etc.) make Roku very convenient though. Even if you're using the secondary functions of a game console or blu-ray plaer to do the same thing--you'll likely find this easier to setup and navigate in my opinion. I have a 360--never use it as a media extender anymore. Same with our (retired) Media Center PC and the blu-ray player's media streaming features. Just not there yet in terms of content/ease of use/cost.
By the way--anyone considering dropping cable needs to realize that while streaming content is plentiful, it's quite different than cable. There's no way I'd have dropped cable for "just" a streaming solution. Netflix, Hulu plus, Amazon Prime--they can all easily get you movies and whatever shows are available on their services, but many, many shows are not available, or available online as only clips or random episodes. Especially newer stuff. And it can be a pain to find stuff--often the web providers are fighting free streaming by changing up things and breaking the streamer's support, or forcing in commercials that you -can't- skip. Playon helps a lot but it still is a bit raw and prone to hiccups.
Streaming alone would not do it, but... a streaming solution (like Roku) for netflix/hulu prime and web-based content, combined with Over the Air HD TV and a DVR is a great way to go. Tons of our choices automatically queued up on the DVR at any time with skippable commercials. Streams and movies for non-network/pbs content. (Sports nuts probably still have to go with cable though.) But you gotta have a good DVR --like a Tivo or (yuck) some other lesser solution.