Drove my first 2005 from 30K to 145K and only replaced the thermostat housing, alternator, front abs sensors, and it went through 2 front right wheel bearings. I towed regularly with it.
When it was totaled I started looking at new trucks but ended up buying a 2003 with 170K because I have a kid in college. This one is 4WD. I see that the 4WD systems requires additional maintenance. This one is on the 2nd transmission. I have a leak in the front differential but the drive train is going strong. I need to do the thermostat housing on this one too. Small leak. I also need to do the bushings the body sits on the frame with to keep it quiet. I have no doubts that I can drive it for 3.5 more years, at which point in time I will upgrade trucks. That was my plan with my old one.
I personally find it to be the right sized truck since I commute 25 miles into a city. It holds my skis so I can go straight to the lake after work. There are newer trucks that get better mileage, though. However, I find most of the new trucks bigger than I need.
So to me the only real con is the gas mileage.
That being said, I know from personal experience that these trucks will take a hell of a collision and despite being totaled, you will walk away with only some body ache from the impact.