I really like Dev-C++, the help file sucks however. There are a number of very helpful sites that cater to questions on Dev-C++. For the language itself, I am using Borland's helpfile instead. Microsoft, Borland 5.5 and Dev-C++ are free on the net. The nice thing about Dev-C++ is that it doesn't take over your computer. Microsoft chews up diskspace in a real hurry with tons of extra files!!
the main extra stuff the free MSVC compiler installs is an updated .NET runtime environment if that's not already installed.
The first program you'd create using the compiler would need that anyhow (unless you specify to not compile for .NET) and anything compiled with VS .NET 2003 will also need it.