Pros
PilotFish is a great environment for business-minded engineers who enjoy both technology and business. Most engineers are exposed both to the product development and professional services side of the business, which means there's an opportunity to wear a bunch of different hats. It's also a great place to get exposed to a variety of technologies and industries, as PilotFish works with both healthcare and insurance clients - some tiny, and some large. There's not a lot of red tape or extra process, so it's easy to carve out a role that works.
Cons
The environment may not be for everyone, particularly those accustomed to larger company environments. The fast paced and customer-centric nature of the work can be stressful if you're not of the right mindset, since there's a constant need to get more done in less time and with fewer resources. Depending on your position, it can be hard to get large chunks of uninterrupted time to get things done.