I know there are a lot of positive things mod-rewrite accomplishes. But are there any negative? Obviously if you have poorly written rules your going to have problems. But
If you're worried about apache's performance, one thing to consider if you have a lot of rewrite rules is to use the "skip" flag. It is a way to skip matching on rules. So, whatever overhead would have been spent on matching is saved.
Be careful though, I was on a project which utilized the "skip" flag a lot, and it made maintenance painful, since it depends on the order in which things are written in the file.