With CME it's fine - you have a fairly reliable, stable device running a (hopefully) stable OS and software that will run for a good while.
On a CM server, you have;
1) PC hardware - with far shorter failure times
2) Windows - which won't run forever, if due to patching requirements, instability, customers tampering becuase they're familiar with Windows, virus problems or updates and so on...
3) CallManager and other pieces of add-on software that may have problems or patching requirements of it's own...
There are just two many things to go wrong on a PC (even on a Linux appliance model to a degree) or that require maintenance to make it worth the outages and support calls to just have one CallManager.
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Agreed, single Call Manager is a bit on the risky side. For a smaller installation you could always consider a single call manager with SRST on the router, but then most installations of that size would just be a CME anyway.
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