We run Orion NPM and all tools on VMware including the SQL backend on a separate Virtual Machine. Our ESX Host has 2xQuadCore2.33GHz Xeons with 16GB of Ram of which we assign 2 virtual CPU's and 4GB of RAM to the Virtual Machines. Orion NPM generally performs ok on this setup although initial entry into the default page takes around 10 seconds or so but other pages load fine, within 2 seconds or so.
SQL Server performs fine in a Virtual Machine and despite what some may say it is very VMware friendly providing you make the right provisions. SQL server will grab as much RAM as you assign to it and keep it which is fine as long as you have enough RAM in the ESX host to cope with that, but on other hand it will relinquish CPU cycles when not required so if you mix this type of VM with other VM which don't require as much RAM but do require more CPU then you have a good balance.