I've never seen a decent autorouter either, and always manually route boards. However...
I worked at a client producing reasonably complex PCBs (essentially a PC motherboard with the usual parts memory, SATA ports, video, etc) and quite often the chap designing the PCBs would modify the schematic in the morning then let the autorouter loose over lunch and farm out the gerbers in the afternoon. The results were, to put it politely, a mess with tracks looping back on themselves and every kind of horror you might hear about autorouting being present somewhere on the boards. Nevertheless, the boards never failed to work (at least, when they did fail it was either a design or software issue).
It is very hard to argue against results (and my colleague at the time joined me in trying!)