The major difficulty is the pretty much constant travel Monday through Thursday, with occasional projects requiring a fly out Sunday night or fly back Friday morning. Air travel seems to have greatly degenerated over the past several years, and local projects are a rarity since I don't live near an industrial part of the country. Projects with extensive travel try to work in periodic work-remote weeks to alleviate travel stress. It's also hard to take 2 or 3 week vacations due to the uncertainty of project schedules, but is possible with enough notice. Since Vesta was a small company, they weren't able to negotiate a good plan with health care insurers, but recently their health care plan has greatly improved.
I gave a relatively low rating to work/life balance since the travel involved with the SAP consulting field is tough on your home life, but in comparison to other SAP consulting firms, Vesta would rate very highly.