I bought this as a third vehicle (instead of a work truck for my rental properties) with about 160k miles. I have owned it for a little over a year and it just hit 170k miles with no major problems. The original owner maintained it well for it's first 160k miles, as have I for the last 10k miles. I do have to replace the power steering pump soon, the loud whine that seems to be a common problem, but otherwise no problems. I have never owned a car with mileage this high so I have no basis for comparison but I am very happy with the reliability.
It also drives great and if the odometer said 50k miles I would believe it. The navigation system seems very modern for a 12 year old car and the leather is in like new condition. We have an Infiniti JX35 with 50k miles and the drivers seat is already more worn than this MDX with 170k miles; they must have used a very high quality/durable leather.
The only downsides are no blue tooth in the 2004, I believe 2005 models have blue tooth, and the interior is small for a 3 row SUV (trade off for handling well for a 3 row SUV).
2004 Acura MDX Touring AWD 4dr SUV w/Entertainment System (3.5L 6cyl 5A)
I have had my car for 4 years and reached 100,000 miles on it and still a great car to drive and dependable. Only changing the oil and brake pads. No problems with maintenance. This car is amazing while in town or traveling on vacation on the highway. Its an All Weather car also. Forget Toyota or Nissan, Acura has definitely made a quality car to last a long time.
Lumbar seat and steering and handling.
After 100,000 believe it or not, no improvements to mention. I am impressed with Acura having a car build to last above 100,000.