V-sync is supposed to help if you have "tearing" issues. Basically sometimes you'll see your screen with a slight tear in it, meaning that the picture is in the middle of a refresh when the monitor re-displays its next frame. What v-sync does is sync up the refresh from the graphics card to the monitor, allowing for a smoother image.
V-sync has issues though if you're playing a game that really stresses the video card to it's limit, since if the signal from the video card is below 60 fps, it knocks it down to 30 fps, or if it's below 30 fps, drops it to 15 fps. Most of the areas within WoW though work great with any modern video card, so I usually leave it enabled as I typically get in the 150+ fps in most areas.
what resolution do you play at to get 150 FPS because that is pretty much determining factor for FPS at this point in wow
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