Chomsky is very passionate about his views. He tends to repeat himself at times in this volume, but the perspectives he brings about US interventionism are certainly very thought-provoking.

Content-wise, I'd say this is the Chomsky you'd expect. His thesis is basically this: US power has declined since WW2, in spite of many focused efforts to maintain and expand that power. These efforts were generally framed as necessary to keep the US (or the world at large) safe. Many of the actions taken in the name of safety were at best foolish, short-sighted and inconsistent with the image we project; and at worst they were violently imperialistic. Claims that these steps were taken for safety are dubious because all the while we have failed to take meaningful steps to mitigate many of the existential threats (nuclear proliferation, climate change) and instead focused on an agenda of advancing immediate interests and influence.

At least, that's my interpretation of it, YMMV.
Whether you agree with some, all, or none of Chomsky's views, he's worth reading because he provides a very different framing of events than you are likely to find in most American media. He is an intellectual giant, and his works are always well-researched (the endnotes here are a treasure trove!)

I have two primary criticisms of this book:
1) As a holistic argument, I feel it lacked some much-needed rhetorical structure. I felt as though I understood the overall "point" only because it was Chomsky, and his point of view is pretty well understood. I think a book as dense as this could use some steps to establish a framework of points or ideas (one example, based on a recurring theme: "US Alliances That Have Hampered National Judgement") and then framed the discussion around those points (for example, in one of the bits about nuclear proliferation treaties: "thus, by failing to set consistent expectations between Israel and Iran, the US has allowed one of its alliance to undermine any moves toward nuclear non-proliferation in the region").
2) This is somewhat related to point 1, but it really reads like a series of 23 essays rather than a book. There is a significant amount of repetition between chapters. In fact, some bits (like the story of the elections in Palestine in which the people voted "the wrong way") were repeated nearly word-for-word between chapters. This makes it a slog at times.

I think that this book is for those that have read Chomsky before. Although heavily sourced, his writing is very polemical, which could turn off a reader who is not familiar with how he does his scholarly work. His research strategy seems to be more clearly outlined in Manufacturing Consent. This is more essay-like in comparison.
I read Manufacturing Consent recently, and it left a pretty big impact on me, but I found that maybe I read it a little too fast and was having trouble recalling the details in conversation. This text recalled many of the same events- this time I took notes. This book being written more recently, also addressed events that took place with the Clinton, Bush Jr, and Obama administrations.
The notes and references are also a treasure trove of information.
If a person is ready for this book, and is interested in peace, I think it can be one of the most important books they read. Many people in US, Britain, and France, are in denial or ignorance of the dark aspects of their international policies in the past decades. This book is a crash course in that.

This was my first Chomsky, and it was everything that I’d expected going in. I’ve seen a few of Chomsky’s debates and speeches, and his opinionated but thorough analyses of world affairs comes across similarly here, along with his penchant for sprinkling playful sarcasm every now and then.

Regarding the US operations in the Middle East, Indo-China and Central America, which are recurring case-studies in the book, there are many horrific events that I know of only thanks to Chomsky's diligent investigating (his documentary Manufacturing Consent is also worth a watch). Chomsky is a force to reckon with in global political discourse, armed with an (enviously) extensive knowledge bank of facts to back him up every step of his argument. While I had an idea of the situation in Cuba following the missile crisis, I was not prepared for the horrors inflicted by the powers in other parts of the world, with little to no regard for humanity. Chomsky does a commendable job in highlighting condemnable actions of past US presidents, and in case you were wondering, it also includes Obama.
The book seemed somewhat structured to drill his case into our heads, but I found that useful anyway. It didn't end with a "What you can do about it" section, but then again Chomsky knows that ordinary people can't really go about their own investigations all the time; it's a job that's best left to public intellectuals. That fact, although a bit unsettling at first, ultimately might to be our best recourse.

I think whether you agree with his analyses or not, there is no denying the need for eye-openers like these to be much more visible in bookstores. And even if the truth evades Chomsky still, at least I can tell his heart is in the right place in starting up a dialogue.