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No extensions (no ReSharper, for example, no Nuget), no integrated source control, no memory/performance profiling, basic UX as compared to full VS - things like that.

edit: - to be fair, Xcode doesn't seem to have a plugin system, but Xcode still is far more capable than Express.

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Correction - you can use NuGet with VS Express.

One thing to consider about costs; to use a $4 version of xcode you have to buy a Mac, so the price differential is probably not as much as you are making out.

I use VS professional at work, VS Express at home, the difference is not that great (only thing I miss is ReSharper, but even that is expensive, about $150 I think)

Having to buy a Mac is a good point. I did not think about that.

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