It's biggest downside was that it was limited to producing 64KB .COM files until version 4 or 5.
https://en.wikipedia.org/wiki/COM_file#DOS_binary_format
EXE (aka MZ) is using other memory models
https://devblogs.microsoft.com/oldnewthing/20200728-00/?p=10...
I know I've used it on CP/M first.
It was really, really fast.