Do we really need this? Why won't position: absolute and setting top/left/bottom/right suffice?
For example it helps when the anchoring element is inside of an oveflow hidden/scroll container, but geometrically you need the tethered element to sit/extend outside of the container (so—for now at least—its DOM node needs to be outside of the container).
The simplest example is if you have content that it not contained by the box you're positioning against. Think tooltips, popovers, etc.
For some usecases like annotating content, this hugely simplifies things.