Chad Callihan shares some thoughts:
A few weeks ago, I had a post about running into some issues due to a database using the FILESTREAM feature. To be fair, the problem wasn’t with FILESTREAM itself, just that I hadn’t accounted for it being in use (or previously in use) while configuring Availability Groups. FILESTREAM has been around for years but isn’t something I’ve seen in use too often. In case you’re not familiar with it, let’s take a brief look at what it is and some gotchas to watch out for.
Filestream is usually not worth it. I did like FileTable, the SQL Server 2012 extension to Filestream that smoothed out some of the rough edges. But even that’s Windows-only and very uncommon to find in environments.