I find it very easy to use. It's a set of 3 attachments. The first one rolls pasta into sheets...
with several settings to roll them thinner and thinner. It's the one I use most, for lasagna and ravioli.
The other two cut the sheets into noodles. One is fetuccini width, which I use fairly often, and the other is for smaller noodles, which I've never used.
They're easy to attach--just unscrew that gizmo in the front and screw in the attachment.
Basically, it's like the Atlas pasta roller, but disassembled into 3 parts. Just like with a hand roller, you have to let the sheets dry a bit before cutting into noodles.
I don't have the "extruders" for spaghetti and such, and I've heard that the don't work very well.