I currently have my game installed on my [D] drive which is a Western Digital 7200 RPM Caviar Black 32mb Cache. I use that drive for storage, applications & programs etc. My [C] Drive is a Western Digital 10000 RPM Raptor that is ONLY used for my Operating System. I'm pretty OCD about keeping both drives clean of excess junk and defragged as needed.

The rest of my system is as follows:

CPU - E8500 Wolfdale
GPU - Nvidia GTX 470
RAM - 8 GB DDR2
OS - Vista Home Basic 64 bit
Sound - Creative Live (older card, but it does what I need it to do)
Monitor - 24" ACER at 1920 x 1200

For the most part Fallout NV runs pretty smooth on my rig at Ultra settings. However, since the new patch it seems that some interior cells really bring my rig to its knees (Repconn Test Site interior to name one.) And that's totally blowing my mind because I never got ANY lag in interior cells before, and they always pretty much ran at a constant 60 fps. That cell can bring me down to below 30 fps in some places which makes a huge difference on my system.

Also, I get the same stutter everybody else gets in exterior cells when far away stuff loads and so forth. I seem to have read somewhere on here that it's caused when stuff loads from the HDD into your RAM? I'm personally skeptical on this being the cause of that type of stutter as it has happens for me with Oblivion and to a lesser degree FO3. (It is actually a LOT worse in Oblivion than FO3 and FNV, lol.)

But am more than willing to switch my install over to my [C] drive just for FNV, but is it even worth going through all the trouble? Do you think it will actually make any difference?

I've found when a patch messes things up it's best to 'delete local content' then reinstall from scratch.

I recently had to use my SATA3 6GB/S Caviar Black 64mb when my SSD died. It was immediately noticeable that the exterior cell loads took a huge hit.

After getting the SSD back and reinstalling W7 and the game it's back to running about as good as it will ever get. (Meaning great for me, though there could always be improvements.)

I'll never not use an SSD again! (Plan to buy a couple more SATA3 versions so even if 1 goes down I always have a spare.)

Yeah, yeah, rub it in! LOL. I can't wait for the price of those things to come down as they're still way too expensive for what you get IMO. I'm tired of shelling out $500 for something and then the price is half that six months later, lol. But such is life in the hardware world.

I have a sata 2 7.2K rpm drive which is where Fallout nv is installed. Realize that some minor stuttering is "normal". The price for streaming the game world off of the drive. Thats better than having a load screen pop up all the time.
I get framerate drops in certain areas too. Mainly in certain vault areas or some sewer areas (there are probably others as well). It can drop to the mid 20's to 30's. So you arent alone in that respect. The drops are tolerable to me since they occur infrequently. You could certainly try installing the game on your 10k drive (you might not see a huge improvement).

72k RPM

Also get a better CPU

What's wrong with the CPU other than being 2 or 3 years old? I built this rig over 2 years ago. These games don't even run dual core efficiently do they, much less quad core? What's the point of quad core if it's not being used by your game?

I'll definitely get a new CPU when I build a new system, but that's gonna be next year at the earliest. BTW, this CPU was one of the best out there when I got it.

It seems that some of the interior cells were designed in such a way that even objects not seen are being rendered by the video card for whatever reason. You'll see this in the repconn facility, vault 21, that mine full of legion peeps, the sewers, some of the other vaults, and a few other places. There is nothing to be done about this. This is what happens when Obsidian hires an amateur from the mod community (the Oblivion mod community too, not the FO3 mod community)

BTW - I can confirm that a good SSD does reduce the stuttering from loading world assets in the exteriors

Eh, I'd ignore the CPU comment. Yours is way more than adequate for this game and majority of the games in the market. The Wolfdale E8500 is no slouch.

People said the same thing about Oblivion's cell loading problems which were worse (and Morrowind's even worse than that!). This is an idiosyncrasy of the gamebryo engine, and can't possibly be blamed on Obsidian who, remember, had only about a year to complete New Vegas. An engine overhaul on Obsidian's part clearly would have been beyond the scope of their obligations.