Fortune's Fool is an innovative game, like Dread, that uses an alternate mechanic for resolution. Where Dread uses the Jenga set, Fortune's Fool uses a tarot deck.
Unlike Dread, where Jenga is only associated with a game, tarot decks are a bit controversial due to their association with the occult. Perhaps a more apt parallel would be if you used a Ouija board as a game mechanic (which, come to think of it, is an interesting idea). If you believe there's no occult connection to the tool in question then it's all harmless fun. But if you believe tarot decks are sacred, then Fortune's Fool is not for you. For the uninitiated, one is never supposed to touch a deck that has been attuned to its owner, making tarot decks uniquely unqualified for use in a RPG.
Given that the tarot deck is such a specialized mechanic, it's odd that Pantheon Press doesn't produce their own PDF or online version. Its availability would certainly bolster the utility of Fortune's Fool and circumvent much of the controversy of using someone else's tarot deck.
The Fortune's Fool setting is a fantasy version of the Renaissance, which poses some challenges for game masters. For one, it requires quite a bit of work on the part of the game master to adapt to the setting, which is not quite Victorian and not quite medieval. It's certainly feasible (see 7th Sea), but it does create another barrier for new players: learning the tarot game mechanic and learning the setting.
The use of tarot cards in a Renaissance setting isn't explicitly made clear in the rules as written. In other words, you could technically use the tarot card system for any resolution, not just the Renaissance. I would have preferred an in-game ability for characters to use tarot cards, like the mechanic for hex-casting in Weird West.
The other challenge is that the real-life analogues to our Renaissance era make for some uncomfortable parallels. Roman elves crucified Christ, their women made barren as a result. Orcs and goblins are primarily Muslim. Fortune's Fool reinforces the importance of avoiding hack-and-slash approach to the traditionally "evil" races, but that doesn’t change the fact that, with over twenty pages focusing on combat, it seems an awful lot like typically violent fantasy games.
Assuming you're not offended by the tarot mechanic, Fortune's Fool is refreshingly player-oriented. Combat and conflict revolves around the player, with modifiers to the player's draw rather than an opposed draw. It's well-written, with relevant examples and short fiction, as well as art that illustrate tarot cards – cards that should have been released as a separate supplement.
The setting of Fortune's Fool makes some tantalizing changes to Earth's history, but isn't fleshed out enough to make it playable out of the box. Game masters would be better served by borrowing a setting wholesale from fiction or other role-playing games. Experienced gamers will likely be intrigued by Fortune's Fool game mechanics, but as a standalone product it's more of a toolkit than a complete role-playing setting. Hopefully Pantheon Press will release future supplements that help round out the Fortune's Fool world.