From one newbie/non-Pro to another, Joost: Milksync lets Outlook on your desktop keep in sync with Exchange servers. Milksync focuses on sync'ing tasks from Outlook with the RTM servers somewhere in the "cloud". You of course then need to use an RTM app, service or widget etc or on your smartphone to sync with the RTM cloud server . At least that's the way I think it all works.

From what I see Milksync runs a desktop service that syncs Outlook (not Exchange) and RTM. If Outlook is used to connect to an Exchange server then the tasks will be updated on the Exchange server.

In order for sync to occur, Outlook and the desktop agent must be running.