This is not exactly a book review, but I have only about fifty or so pages left to read, so I decided to put down my thoughts all the same.
Most of what Chomsky says is just confirmation of what I have already known or have at least felt intuitively to be true, but he provides plenty of footnotes as evidence (pity the footnotes are not available in the book itself -- you will have to visit the web site for this, but the fact that they exist is comforting enough; going by Chomsky's reputation, they are sure to be rock solid).
Chomsky is under no illusion that he is somebody around whom like-minded people can rally and look to for guidance. He simply claims to be playing the role of an observer who brings things to people's notice; it is up to them to decide how best to act upon this information. Having thus established his role (since he is no messiah, don't look to him for quick and easy solutions to the mess we are in), he is then free to take a pretty pessimistic outlook on things. By the time you reach the end of the book, you have gained a lot of insight and knowledge, but there is no sense of hope, that things are on the right track and will get better and so on.
BTW, even if one dismisses the book as the ranting of a liberal firmly on the left of the aisle, I would consider it to be mandatory reading, at least to disabuse one's notions about how the global capitalist economy really functions and how free the 'free markets' really are.