I've written many NIFs for Erlang that call out to high-performance C routines when "number crunching" is most important. I've also done it to side-step memory allocator churn for implementing binary protocols that support zero-copy semantics like Capnp by using the NIF as a kind of escape hatch where I can fiddle bits in a buffer directly.
In fact, somewhat lazily since it's low priority, I'm trying to create a decent Rust wrapper for the NIF interface so that I can attempt to get more compile time safety out of the dangerous stuff I do outside BEAM's safety net.
Other than being dangerous, since a segfault will bring down the whole VM, the other big issue is these calls block the scheduler (basically breaking the VM's preemptive abilities and creating the same limitations Akka on the JVM has when you block all the threads in an ActorSystem). However, now that R18 has dirty-scheduler support it's much easier to avoid this problem by quarantining that stuff on threads that don't muck with executing normal bytecode.