PDF-T-Maker is a free add-in to Microsoft Word for creating rich PDF documents. Normally, using tools like PDFCreator is enough when I want to output to PDF files. However, sometimes when I need to create a PDF document with table of contents and links, PDF-T-Maker is a good replacement for Acrobat. The idea is that I create the rich document is MS Word, then have PDF-T-Maker convert it to PDF with the meta information preserved.
One thing that bugs me however, is that after installing this add-in I then get the Security Warning dialog every time I launch Word.