What version are you running and which plattform?
Its Adobe Reader X on windows XP
The same problems...
Some PDFs are OK, some of them cannot be printed correctly.
It look like Reader X ignores "Print as image button".
I have the same issue. In Reader X, some PDFs print fine while others come out garbage. However, I can get correct (but *VERY* slow) printing by turning on the "Print as Image". This is definitely a bug in Reader X (may have existed in late 9.x as well) as some of the garbage PDFs printed fine a year or so ago in Reader 9.x.