Although I found the book enjoyable, I also found it difficult to follow. There are too many characters. A list would have helped immensely. Most of the characters aren’t developed, but it takes a bit to see which are which.
The setting is fantasy, but has few fantastic elements to it until the end. Several times the story suggests the onset of a long (several years long) winter looming, presumably this unfold in a future volume. Their seasons do not seem to be regular intervals. There are also a lot of allusions to dragons.
The story is rather violent. Although far from gratuitous, it seems to convey a feeling for the period. It is gruesome at times.
The story focuses on power grab for the throne of Winterfell, the story has strong allusions to the War of the Roses. There are two houses vying for power and contrasting each other in a very simple good vs. evil story. First is the Stark family, lead by Eddard. He is the epitome of honor. This house if countered by the Lannisters who use trickery to attain their ends when it forwards their goals.
The book is told from a number of viewpoints. To make this a little easier, the focal character of each section is identified as a title. The rapid shit from viewpoint to viewpoint and the cast of characters makes it a challenge to follow at times.
Overall, the story is good. I enjoyed the intrigue, the plots and counter-plots. I think some of the characters could have behaved more intelligently, but it didn’t detract too much from the story.