Name your top 5 Must Haves....

[ZephyrZodiac]

Specially since it's about the only non fun or charisma skill want that Romance, Popularity and Pleasure sims get!

[KnightSkyKyte]

I'm torn between hacks and custom content... and also between what is useful and why I play the game... oh, who am I kiidding? Anything that indulges my YAOI fantasies has got to be first, or I wouldn't be playing the game at all

For hacks:

1. 2Jeffs preg for all genders, same sex marriage, have child not adopt
2. Crammyboy's Cock Hack
3. Macrotastics
4. Autoyak & Phone hack
5. Coffecup hack
 
For Custom content:

1. Beosboxboy's realistic skin I adapted for #2 above
2. Invisible clothes for male sims
3. Custom hair for male sims
4. Clothing that makes male sims look sexy
5. A damn good MALE sim skin... haven't found one I really, really like yet though...

[Batelle]

When it's all said and done, I could live without custom content (although I love me some realistic eyes and have Helaene's as my default) but there are a few hacks that, were it not for them, I would have given up on the game within a few months

1. Merola's Multi-painting- I hate that CAS sims are such blank slates and, being SpimPE impaired, this is the easiest way for me to fine tune personalities, skill sets and interests without having to waste a bunch of time getting them up to standard.  I also like having the ability to adjust specific moods, especially when glitches happen in my Legacy houses. 
2. College adjuster- Even in non-cheat situations, I'm a slave driver at Uni.  I can get the semester grade filled up in a fraction of the time that Maxi allots and not having the option to "fast forward" the semester would kill my gaming momentum.
3. TwoJeff's Same-sex marriage, preg for all genders, have child not adopt-  Equality for all sims! 
4. Abduction hack- My first hack ever (and the one that has, admittedly, been most abused). 
5. Inge's teleporter shrub-  I don't know how I lived without it.  Not only has it made matchmaking a breeze, used in in tandem with Dr. Vu's plastic surgery machine, it's increased the Townie attractiveness quotient tenfold.

[Muisie]

1.  phone hack (with talk till you drop dead)
2.  greater LTW variety
3.  college adjuster
4.  homework sometimes faster fun
5.  no secret society abduction

The phone hack being the absolute number one essential component keeping me from committing felonious homicide.

Edit:  Holy crap, I forgot about the LTW variety hack.  Can't do without that!  Readjusted my list.

[ZephyrZodiac]

I found that with the NL version of the phone hack they don't talk for so long as they did before, not even always till their meter is full.  Once they have made a sim a friend I use the Autoyak much more!