One of the things I like about Tahoe is skiing all day then gambling for a few hours in the evening. This makes for a long & tiring day, however. The Tahoe casinos aren't all that exciting, though - they don't merit a gambling trip in and of themselves, but they are a nice distraction. In South Lake Tahoe, I like Harvey's and Harrah's.
I'm thinking if I get to that area again, though, I would stay in Reno - more casinos, pretty cheap room rates. A friend who goes every year (partially for a convention, and some skiing) swears by the Reno Hilton as a great place to stay.
I don't gamble enough to get comps, and, I don't want the gambling to cut into my skiiing time, so I wouldn't even try to get comps.
When I really want some gambling, obviously, Las Vegas is the best, but the accessibility of gambling in the Tahoe area is what got me out West for skiing the first time.