I use it to run physics simulations (on a backend server) for a game.
Node.js has a bunch of nice features:
1) It's heavily optimized (V8, SpiderMonkey, etc). My crude benchmarks are about half as fast as C++ (IIRC).
2) It compiles fast (compared to C++).
3) You can run it in the browser and the server
My original plan was to run it in C++ (for speed) on the backend servers, but then it was fast enough. If the game ever gets huge traction, I'll probably go back to C++ for speed, but until then, it's plenty fast enough.