I have, as many others, tons of stuff on my desktop. The windows box in question is a Vista machine and I really like the fixes MS has done to the user experience since XP. But I always had trouble with all my desktop icons and my fetish to save to the desktop when it's only a temporary file, that always stays there for weeks or months when it's not so temp anymore. The biggest issue is that it's a laptop running at 1440x900px docked but not so high resolution undocked. When I have placed all my tools and stuff neatly along the sides of the screen and undock my laptop all the icons go together in a big pile in the top left corner. So when I dock again I have to tidy up all the time. Now I don't have that problem anymore! Fences really cleans up the desktop and take care of all the problems. It's good, it's easy and free!
Check it out: http://www.stardock.com/products/fences/