Wow, most American cars are less expensive to repair than the ES350. In my opinion, you are taking a risk. Too many things can (and have) go wrong on this car.

I don't have an extended warranty, but I get rid of my cars just prior to 50K miles.

 

Lexus comes with the upgraded luxury car warranty of 4 years 50k bumper to bumper and 7 years 70k power train, that will cover most of the drivers here but not all.

With that said my 03 V8 Limited 4Runner that I got with an extended warranty paid for itself, just the electronics that went wrong with the vehicle that needed to be replaced, the warranty cost me $800 and cost of labor/parts was $7000, nothing mechanical ever went wrong.

An extended warranty is nothing more then insurance, you never intend to use it but it's there just in case, my 4Runner had a headlight with condensation building up inside it and without question Toyota replaced the housing, that housing cost $320.

I would say an extended warranty is a must, email a bunch of Lexus dealer see who gives the lowest quote and purchase from them, my brothers 300c has a lifetime bumper to bumper warranty and the Chrysler dealer originally wanted $3500 and we found a dealer with a quote of $2000 and then our dealer matched it.

Cars are expensive to own and a dealer will empty your wallet trying to fix something so keep that in mind, a warranty should almost be figured into the price of the car from the get go.