This appears to me to be an attempt by Ferguson to provide a sort of sequel to Guns, Germs and Steel. I say that because both books begin the same way - the attempt to answer a question about Europe's predominance over the last few hundred years and because Ferguson makes multiple reference's to Diamond. I am guessing Ferguson was not entirely satisfied with Diamond's explanation and sought to get more detailed about the rise of Europe.
If you could get past the horribly self-congratulatory preface - if your edition is unfortunate to have it - I think he does a somewhat reasonable job of attempting this alternative explanation. (But about that preface: it may be the most self-congratulatory preface I have ever read. It is horrible. Please stick with the book if it sickens you. Or skip it altogether.)
The first few chapters are quite compelling and generally well done. Where Ferguson has problems is when he gets to "Medicine", "Consumption" and "Work Ethic." It seems that Ferguson is struggling to explain exactly how these things affected the world - and led to European dominance - in part because he wants to tell other stories: in the case of "Medicine" it is the incredibly interesting story of how the Germans practiced ethnic cleansing in Africa well before the Nazis took over; in the case of "Work Ethic" its a far less effective lecture as to how our lack of faith is somehow destroying us morally (definitely the lowlight of the book). These may be interesting issues - I am going to hopefully read more into the German colonization of Africa - but they are really not relevant in any way I can see. And all three of these chapters are afflicted by this problem - they are entirely too tangential.
Fortunately the conclusion is rather fascinating and, if you can handle Ferguson's very, very pro-Western stance, quite illuminating, to the extent that they mostly make up for the rather clumsy and confused second half of the book. Ferguson's suggestion that we should reject the cyclical view of history in favour of one based on the scientific understanding of complexity is particularly well taken and reason alone to read the book.
On the whole I'd say it's worth reading, though it has enough problems that anyone who finds Ferguson's public persona annoying will probably not be able to enjoy it. Fortunately I try to avoid everything but his books, so I didn't have that problem. It's a flawed but interesting account of recent world history.