Microsoft Azure SQL Database Reviews

We're a healthcare organization hosting EHR systems like NextGen, Allscripts, Athena, and ECW, which require an SQL back end. We have a lot of NextGen clients who need a production SQL Server, a reporting server, and maybe a test server. We set up AO clusters if they have enterprise licensing, and we also do physical servers, depending on the client. 

We use Nutanix infrastructure and are moving more to Azure and AWS. We integrate SQL Servers for our clients, matching set-ups with their financial capacity and licensing. 

Overall, Azure SQL has been great. The ease of deployment and scalability are significant reasons we push our larger clients to Azure. We could throw the kitchen sink at the thing if we wanted. 

We use Azure Hybrid Benefit, depending on the client. We work with many nonprofits, and we always make reservations because you save tons of money. Normally, when we do our initial deployment, the first month's bill is sky-high. We build out the environment and servers, then we do the reservations. Of course, we will enable the hybrid licensing depending on the client. It saves time because everything is in one pane of glass it just simplifies the deployment of things. 

Azure SQL has improved our productivity. We try to customize with alerts to gain visibility into SQL. We have dedicated DBAs to do the SQL coding work, especially when it comes to specific EHRs or client-specific.

The deployment was straightforward, and the overall experience was very positive. I feel like I could do SQL migrations blindfolded. We onboard a lot of clients that have as many as 1,500 users. We're migrating from our private cloud to Azure or AWS, so it all goes hand in hand. I'm typically not involved with deployment. Once they set up the SQL clusters, I ensure everything runs like it did before. 

We're starting to implement more AI solutions. For example, we have a custom dev team that does live archiving. If the EHR system goes down, they have another way to access patient records and images. We have another new product called ChartAI that's integrated with AI to do dictation and handle things involving charts. It saves the practitioners and doctors time by automating processes and simplifying things. We integrate with multiple platforms across the board, and we've never had any issues. It's pretty seamless. 

Microsoft is at the forefront of databases, and everyone uses SQL. It's a reliable, solid platform.

Improvement could be made in the performance tools, offering a better overview of core issues like process activity and latency, as we currently rely on third-party tools and SQL jobs for monitoring and alerts. A comprehensive built-in solution for performance analysis would also be beneficial.

I have used SQL databases for around 20 years, and I have worked with my current organization for five years.

The latency and availability of Microsoft Azure SQL have been great. It's always been reliable. The only issue we've had has been connectivity between sites like the SonicWall locking up. SQL never crashes or suddenly becomes unavailable.

It's easy to scale Azure SQL. Scalability is critical because we can only scale so much in our private cloud. Our clients choose to have physical SQL clusters. Scalability is big for our large clients because we can always increase. 

We haven't had needed to open a ticket to customer service, but the great thing is that there's so much information online that you can troubleshoot your issues without getting support involved.

Positive

I have the deployment down to a science. We cut everything over and build it from scratch on the other side. We use Nutanix Move to move SQL databases between data centers if needed and set up the core databases or the support server. The day of the cutover, we back it up, stop the database, and restore it. From there, we're putting all the SQL logins back in and doing the maintenance jobs. 

I've seen significant cost savings due to hybrid licensing and reservations. Initially, the costs might be high, but savings occur once everything is in place and reservations are applied.

It greatly reduces the total cost of ownership through efficient licensing depending on the client, the cost savings, and hybrid benefits. We aim for a blend of organizational and client-owned licensing.

I rate Microsoft Azure SQL 10 out of 10.

Azure SQL serves a variety of purposes across our client base. It supports both customer-facing and internal products, depending on the specific needs of each client.

Using Azure SQL Database is not difficult.

I'm excited about the Azure SQL database's ability to power next-generation AI applications because its capabilities unlock greater potential.

The Azure Hybrid Benefit simplifies the process of migrating servers to the cloud by reducing the licensing complexities and costs associated with running Windows Server or SQL Server workloads in Azure.

Integrating Azure SQL database with other Microsoft applications is easy. For someone with my level of experience, it is not complicated at all. 

We remain committed to delivering our services with consistent willingness and enthusiasm. Utilizing Azure SQL Database has enabled us to maintain our productivity levels without interruption. This technology significantly enhances our operational efficiency.

Azure SQL Database has significantly reduced our total cost of ownership by eliminating the need for managing physical infrastructure, including data warehouses and data centers.

The integration with Azure Data Factory is seamless and straightforward, described as just a click away. From my experience, this integration is not overly complicated for someone at my level. However, it might be challenging for a newcomer. Additionally, Azure SQL helps in reducing the company's total cost of ownership because we don't have to manage on-premises infrastructure. Migrating servers is easier, and there is less concern about licensing. These features also aid in cost reduction.

Sometimes, we encounter limitations due to our use of a government cloud environment, which differs from commercial cloud platforms. Certain features available commercially may not be applicable in our gov cloud. To overcome this, we collaborated with the network team to develop alternative solutions. We always approach tasks with multiple plans, A, B, and C to proactively address potential challenges and avoid reactive problem-solving.

I have been using Microsoft Azure SQL Database for two years.

The latency and availability of the Azure SQL database have been satisfactory thus far.

As Azure SQL database is a Platform-as-a-Service offering managed by Microsoft, we are confident in its ability to scale workloads effectively.

Microsoft provides excellent service and is always available to support us. They are very supportive and engaged.

Positive

We were predominantly a Microsoft shop, and choosing Azure SQL was a natural progression from on-premises to the cloud.

I would rate Azure SQL eight out of ten. This is because things change frequently, bringing new features and capabilities we haven't fully explored yet. I always leave room for growth, considering potential challenges we haven't encountered.

Microsoft's SQL Server expertise was a key factor in our decision to adopt their cloud database solutions. Their consistent support and readily available communication have proven invaluable, particularly the helpful human interaction we've experienced.

We use Microsoft Azure SQL Database mainly for the backend of the transaction of data. It is used for various sectors like healthcare, patient data, and ERP.

Azure SQL's user interface makes it easy to provision a database. It integrates well on the back end with our functions and logic apps. While Azure SQL is probably not a good fit for running AI-based applications on top of it, AI might provide better performance monitoring or bottleneck analysis. AI can help the SQL server operate better. 

There is a need for dynamic scaling support without losing current transactions. That should be part of the standard offering to SKUs. It doesn't have Auto SQL. We have HyperSQL, but there are limitations on the Elastic Pool. It only allows 25 databases. It would help if we could automatically analyze and optimize long-running queries instead of handling these tasks manually. 

We have been using Azure SQL Database for about 10 years.

For our solution, Microsoft Azure SQL Database has been accessible, though there are performance bottlenecks related to old code and long-running or poorly optimized queries.

Scaling is primarily manual unless using Elastic Pool. Automatic scaling without transaction loss is a desired feature. Scalability could be improved with auto scale options.

Our interaction with Microsoft has been limited as our team is experienced. However, we recently worked with Microsoft on the new database watcher feature and confirmed limits for the hyperscale with Elastic Pool.

Positive

Our solution was initially built for an on-premises data center using SQL Server as the backend. Moving to Azure, we continued with Azure SQL Database because it supports the majority of needed functionalities.

We used managed instances and standard offerings to manage the transition from on-prem data hosting to Azure, given the lack of auto-scaling.

Our internal DBA team handled the implementation, leveraging their expertise to ensure a smooth process.

Our main savings come from using Elastic Pool, which reduces costs by 30 to 40 percent for multiple databases and 10 percent from vCore provisioning. The serverless feature should save a lot, but the database is rarely paused or parked, so we don't save as much as we should. 

We do not use Azure Hybrid Benefits because of company policy. Hence, all licensing costs are associated with Azure SQL licensing rather than bringing on-prem licenses to Azure.

Options like Cosmos DB and vector databases are considered for AI applications. However, we stay with Azure SQL for transactional data stores.

I rate Microsoft Azure SQL Database nine out of 10. It's still missing some features, so I deducted one point. 

We use Microsoft Azure SQL Database to extract HR-related data from SAP and Dayforce, like salaries and employee information. This also involves maintaining different environments for previous ERP systems like AX Dynamics and transitioning to SAP in 2022. We have development databases for unvalidated or unapproved data, as well as production databases.

Microsoft Azure SQL Database has significantly improved our operations by allowing us to extract data and generate comprehensive reports in Power BI. This enables a high-level overview of our operations, which helps us look at the entire picture instead of analyzing individual orders line by line. This increased accessibility to data enhances productivity.

The ability to maintain different environments, such as development and production databases, is valuable. The ability to use the same interface when connecting to on-premises databases or data lakes is very convenient. It's easy to use Azure SQL. Writing queries is the same as on-prem SQL. 

Azure SQL's ability to power next-generation AI applications is pretty nice. They're doing previews now for all that stuff in Fabric, so I could take all the data from there instead of Power BI reports. We don't use that for machine learning.

Azure SQL integrates very well with other Microsoft applications. We have to take date from on-prem servers and forklift it into the cloud, which is pretty simple once you have it all set up. After that, it's copy and paste.

Microsoft Azure SQL Database could be improved by offering an easier way to view all existing roles in the database without needing complex queries found online.

The company has used Azure SQL for three or four years, while I have used the solution for around two years.

Overall, the stability is satisfactory. Even with a large amount of data, performance is generally quick. Adding an index resolves any speed issues that might arise.

Azure SQL's scalability is excellent, particularly when using Azure Data Factory for data transfer. Despite mainly storing the database, it is efficient for transactional purposes.

Migration isn't simple when doing some things in the cloud, like importing Excel data or workbooks. It's a lot easier with on-prem stuff than in the cloud. That would be a bigger hoop to jump through now. After you do it once, you understand what you need to do the next time.

The use of Microsoft Azure SQL Database has not significantly reduced total cost of ownership due to the manual process required for moving data out of SAP. However, it enhances productivity by allowing power users to manage data independently.

I rate Azure SQL Database eight out of 10.

The only use case I have for the Microsoft Azure SQL Database is this data lake. The client decided that they want to concentrate all integrations between systems on the Azure SQL Server on the cloud to just be the repository of the interface. Every system that needs to transfer data from each other puts the information on the data lake on the SQL Server, and the other system gets it from there. I believe that's not a good solution, but the client wants to do it this way.

The Microsoft Azure SQL Database performs effectively, and if money is not a problem, you can scale. It can grow, and with a click of a button, you can add more memory and more CPU. This is a good feature if you need it and if you have the resources to invest in these capabilities.

The initial setup for the Microsoft Azure SQL Database is straightforward, as with all Microsoft tools. It's usually easy to set up and get running. Management is consistent, which is beneficial. You can manage your Azure instance with the same tools, Management Studio, from your computer. You can treat it as a box in your house.

I have used the Microsoft Azure SQL Database for two years now, and I don't find it satisfactory. It's slow and expensive.

The Microsoft Azure SQL Database is not the latest version of Microsoft SQL Server. I believe it's a really old engine that does not have the newest features. It's very slow and too expensive. I really don't think it's a good solution for most cases, except when you specifically need to put your data on the cloud.

Regarding stability, the Microsoft Azure SQL Database is very stable, but I noticed very poor performance. My client bought a specific configuration with some memory and two cores only. This configuration performs very badly compared to the same situation on-premises. Even if I put my SQL Server on an old machine, I will get better performance from the hardware on-premises.

There are problems with connection, and I believe most clients would be better served by a database on-premises. There is also an issue with extracting data - you cannot do a backup and dump the database to your local network. You need to rely on Microsoft backups to restore your data and pay for it. I really think that the data belongs to the client, and the client should always have the ability to download their data.

I have used the Microsoft Azure SQL Database for two years now, and I don't find it satisfactory.

The pricing for the Microsoft Azure SQL Database is expensive, though I don't have the current numbers as I saw these figures more than a year ago when preparing the environment. The client is already planning to move back on-premises because it is not working well in terms of performance. Now that we are starting to move big volumes of data, the system starts to slow down. Queries are slow, and the performance is now impacting the application.

I would rate the Microsoft support for this product as poor because we did not use it. The client just pays for the storage. We have some kind of built-in support, but we never used it as we try to figure things out by ourselves. In Brazil, this is a little bit more complicated. They have used the support from Microsoft for other products. They have Microsoft Windows 365 and volume licensing with Microsoft. They use their support, and I know that it works. On the database part, I didn't use it.

In general, I would give Microsoft support a rating of six out of ten.

The initial setup for the Microsoft Azure SQL Database is straightforward as with all Microsoft tools. It's usually easy to set up and get running. Management is consistent, and you can manage your Azure instance with the same tools, Management Studio, from your computer.

My client does not use Amazon services at all, including the Azure Data Box.

I am not familiar with just the Data Lake Storage because we are just using the SQL Server database, not the other products that are supposed to be dedicated to this kind of use of a data lake.

The Microsoft Azure SQL Database is not the latest version of Microsoft SQL Server. It's a really old engine that does not have the newest features. It's very slow and too expensive. I really don't think it's a good solution for most cases, except when you specifically need to put your data on the cloud.

The client is already planning to move back on-premises because it is not working well in terms of performance. Now that we are starting to move big volumes of data, the system starts to slow down. Queries are slow, and the performance is impacting the application.

On a scale of one to ten, I rate this solution a six.

We use SQL Server to hold most of our data, including orders and invoices that we're currently syncing with. We also have some customer and location data, which are the main uses.

It's easy to work with large amounts of data, query it, and bring it back to a visualization tool to show it to the end users.

The ease of use of SQL Server is among the most valuable aspects. Coming from a Microsoft background, it is especially easy to connect and work with SQL Server. Developing .NET applications is easier with SQL Server as a background. The ability to easily integrate with other Microsoft applications has also helped.

One area for improvement is data virtualization. Companies use different data sources, creating a separate data virtualization layer, and there are more data sources behind that layer. For example, we have different data layers for Excel, SQL Server, PostgreSQL, etc. Creating a data virtualization layer would help because you retain the metadata of your source data. 

There are many things in the back. If I want to query millions of rows in the background and have five sources. I must join those sources to the left or right and optimize the result. We cannot pull five million records, store them in a table, and query those. It will be a problem and time-consuming. We want instant data. 

I have used SQL Server since I joined the company five years ago.

The availability and latency have been pretty good.

SQL Server has the ability to scale workloads effectively.

Expertise and knowledge from Microsoft were important to us when considering servers.

Positive

It has helped considerably reduce our total overhead cost, but I do not have the exact numbers.

I rate Microsoft Azure SQL Database 10 out of 10. 

Our organization utilizes Microsoft Azure SQL Database to support our Dynamics 365 business suite, and we also leverage Azure Virtual Machines for deploying SQL Server instances to accommodate other applications.

Microsoft Azure SQL Database runs naturally, allowing us to use it as a service without worrying about infrastructure or deploying servers. This has improved deployment speed as it's one less server to deploy, freeing up time for us.

We utilize Azure Hybrid Benefit daily as it provides a framework for deploying business applications within cloud-based virtual machines. This approach significantly reduces deployment time, requiring only a few clicks and a few hours of waiting before the virtual machine is ready for development and testing.

Azure SQL Database integrates well with other Microsoft products, which is critical.

Azure SQL Database offers strong performance, effectively managing tasks like tuning and indexing, which eliminates manual optimization and frees up our time for other priorities.

Azure SQL Database has significantly reduced our total cost of ownership. By utilizing it as a service, we have eliminated the need for physical servers and their redundant counterparts, which were previously necessary.

We use SQL Server as the back end for indexing performance.  

We appreciate that Microsoft Azure SQL Database supplies reliability and efficiency with its infrastructure, which is very beneficial to our organization. Furthermore, by using it as a service, we improve load scalability without experiencing major performance issues.

In terms of improvement, making Microsoft Azure SQL Database faster would cater to big companies that require speed. Additionally, having more statistics to help improve queries would be beneficial.

I have been using Microsoft Azure SQL Database for ten years.

We have not encountered any stability issues with Microsoft Azure SQL Database. Our relatively small customer base may contribute to this positive experience, but so far, the Azure SQL Database has performed excellently with no latency issues.

Azure SQL Database's ability to scale loads is a significant benefit.

We had a physical server with a redundancy server in the past, and now with Microsoft Azure SQL Database, that requirement is lessened.

The deployment of the Microsoft Azure SQL Database required additional configuration to establish connections and access data due to enhanced security measures. However, once operational, it functions similarly to a standard SQL Server.

Microsoft Azure SQL Database is not cheap.

I would rate Microsoft Azure SQL Database an eight out of ten. We should get more statistics to improve query performance. The SQL database is tied with Dynamics, so no other databases are viable.

We are not using Azure SQL Database much with AI, but it looks promising, and we are looking forward to those capabilities. 

Our primary use cases are logging for behavioral analysis similar to Google Analytics and transaction logging for our web pages for customers.

We use Azure Hybrid Benefit because we're a legacy company, and we have a SQL database from many years ago. We are migrating some databases to the cloud have seen a nice reduction in costs using this hybrid benefit. Shifting our corporate programs to the cloud is more or less the same due to the ease of implementation. We've cut costs by around 70 percent. 

Azure SQL is easy and feels similar to on-premise systems. The cloud solution is effortless to set up.

One area for improvement is setting up logs, especially for servers like VM SQL. It was also tricky to connect services on VNets to on-premise. We also had difficulty integrating some Azure resources. For example, app services in Azure Kubernetes may be difficult to integrate if these servers are on a VNet.  Semantic search or vector search should be enabled by default.

We have been using Azure SQL Database for about two years.

Azure SQL's latency was amazing with local data storage, but we had challenges using external tables in packets and delta tables. We're facing some high latencies, about one or five seconds for small packets delta tables. This could be improved.

We haven't utilized workloads for Azure SQL Database's scalability. We employ stored procedures for processing alongside database externals, making scalability less tested on our end.

The Microsoft support plan has a one-hour SLA, which was crucial in our decision-making process regarding database options.

Positive

We previously used VM SQL and have SQL Managed Instance now. We are not using Azure SQL database to power AI applications. We use NetGood Database SQL 2025 to search.

We had to migrate some legacy SQL databases to the cloud. The process went smoothly.

We reduced our TCO using Azure SQL.

I would rate Microsoft Azure SQL Database eight out of 10. If VNet integration was improved, I would rate it higher. The integration with VNets was a critical issue.