Limited career advancement opportunity if you are unable to relocate
Limited marketing presence (although this has gotten much better in recent years)
No home office expenses allowed (including internet, office supplies)
Salaries are lower than competition unless you prove yourself - then they make it right
Many decisions are made by main office in Israel - sometimes these decisions don't fit well with the US market.
High sales team turnover (usually because the people hired were just not capable of doing the job)