I have mine at 42" which is perfect for viewing, the downside of course which you already mentioned is having to be on a ladder or stool to work on it. I find myself inside that my tank more than I thought I would be.I just transferred everything into last month so fine tuning placement of things has slowed down some. The other drawback is I have a viewing glass to look down at corals which is well worth the effort of using. I plan on building a small platform to be able to allow others to view it. If I had to do it again I would stay at 42" it's at the average viewing height of most and allows for a great overall look at tank.