It does a pretty decent job on small hobby-project boards of ~40 components (which is my use case at the moment), and I'm working part-time in the background on scaling it further.
The resulting designs pass all the KiCad electrical and geometry checks. Granted, I've spent about a year working on this problem, and it's hard, but not that hard a problem, providing you can avoid falling off the exponential cliff by decomposing it into hierarchical subproblems.
Quick-and-dirty unsupervised whole-board synthesis from schematic takes about 5 minutes, longer if you want cleaner output with nicer-looking better-routed traces.
As others here have said, placing is the real problem to solve, and that's where the magic happens. Place the components right, and routing is a relatively easy loosely-coupled constraint programming problem, place them wrongly, and you will have to get used to seeing the word UNFEASIBLE in your log output.