I always try to use only free stuff -- especially if I have to buy things from Micro$oft -- so, just as an experiment, I attempted to build pywin32 (current CVS as of 2009-06-05) using the current free compiler on my Vista laptop. It worked much better than I expected, but setup.py finally crashed with:
v v v v v
Microsoft Windows [Version 6.0.6002]
...
C:\pywin32>c:\python26\python.exe...