Obviously the first ad links in google don’t work any more, which drives the wife crazy ;-) Also nowadays more and more websites complain about me using an adblocker.

But technically, not really any problems at all.

In the 6 years I've ran mine, I've not had any issues and I run a blocklist with over 1 million domains on it.

If I was to run into something that's blocked that I do want loaded, I can just open the pihole interface and either whitelist the blocked domain or disable blocking for a short time, each with just a couple clicks.