Nice atmospheric music. A lot of it is pretty good, and it'd set the feel. My only gripes are that there are a lot of shorter songs, which wouldn't always last for terribly long in terms of play time, so if you were running a campaign, you would have to constantly fiddle with the music player. My second gripe is that a lot of the music is pretty much carnival-only. Some could be applied more liberally to other creepy mood based settings, but a GM would have to get players to a carnival, and looking through the mass of settings I have, the only ones that work with that are Spycraft (gimmicky), Shadowrun, d20 Modern, and maybe (very gimmicky) Heavy Gear or MechWarrior as a side-plot (though this may be somewhat due to my lack of knowledge of carnivals and how to work them into other settings).
Oh yeah, I have another gripe: The laughing samples: No subtlety. It's like the music is saying "Be scared!" rather than "Big bad things lurk here!".
[4 of 5 Stars!]