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They serve contextual display advertisements.

The reason that their ads are effective is because they are frequently disguised as navigation.

I still made more money with AdSense though, and it feels a little less dirty...

LOL, the business model seems to fit pretty well to the douchiness of this guy.

How did you decide that the guy was douchy? Having money and spending it shouldn't be the criteria for it.

By most accounts, his company is a great place to work in.

Let's not forget that before it got on its high horse (after making billions upon billions), Google was pretty okay with letting people advertise scammy stuff on AdWords too, as was Facebook (just ask people about the glory days of the "Rich Jerk" or dating offers on Facebook)

Last I heard their niche was they resell adspace on websites that Google Adsense et all refuse to do business with for one reason or another

Partially true. Most people I know use it to fill out unused inventory. You can't have more than 3 (or 4? can't remember) AdSense ads on page. But no one is stopping you from using 3 AdSense ads and 4-5 Media.net ads

Essentially it's the Adsense rival Yahoo uses