Well, I mean, when you're doing image uploads in a multi-server environment and that image needs to be available to all servers immediately - e.g. for a news article.
You can either upload the image and then mess about with sending it via FTP to the other servers, during which of course you must generate unique filenames and check that filename isn't in use on any of your servers before proceeding. Then when you come to delete the news story, you have to locate the image on each of the servers and remove them too.
Or you can keep that image in the database and let it replicate across your servers automatically. Then, of course, when you come to delete the story, the image goes with it anyway.
Which sounds easier to you? :-)
I quite agree with the basic principle that images-in-a-database is A Bad Thing (TM) 99.9% of the time - but as a tool it has its uses.
--Mike