http://www.bluebeam.com/I've been using this as my preferred PDF editor for years now. I've always been surprised by how little I hear around the web about this program. So, yesterday, while talking to a support staff member, I asked why so little is heard about it. Basically, they don't do any advertising and rely on word of mouth. And they do fine like that, so they're happy. Also, he said the application initially was geared towards the architectural industry needs (CAD drawings, designs, etc.). However, that was a long time ago. I think the program is fantastic for any kind of serious editing of pdf's.
I've tried many Acrobat Pro alternatives, but Bluebeam is the best by far. First of all, it's on version 7 now, and it's VERY polished. They're really ironed out any rough edges over the years. It's not that it can do anything than Acrobat can't, it's just that it does it far easier, and everything is accessible a lot more intuitively. I'm in love with this program.
But it is kind of expensive, like Acrobat. So a lot of individual users would find it out of their price range. I'm very thankful my company continues to upgrade the licensing...I actually think it gets charged automatically without them knowing because i think I'm the only one using it! Everyone is using Acrobat 9 here now. But I'm not saying anything because i don't want them thinking they're spending a lot of money on two redundant applications. Then i'd have to convince them to keep Bluebeam, but I'd be the only one, blah blah.
Anyway, for anybody that spends a lot of time editing pdfs, importing/exporting, creating pdfs, it's really the best application I've seen for that.
Below is my screenshot of it:
Bluebeam (AWESOME pdf editor, Acrobat alternative)