Its a system administrator duty to be sure the ESX servers health and performance are OK.
I monitor:

ESX Monitoring
ESX Monitoring

I believe the most important things to monitor are:
CPU check_cpu_esx
DISK check_disk
VOLUMES (storage) check_vfs
Hardware (Fan,Temp,Arrays,Memory Dimms,Disks etc…)

I have tested all checks with ESX 4, HP or Dell Hardware.
For the hardware checks to work you will need to install
Dell Open Manager or HP Insight Manager
I have other scripts that monitor number of VMs and other details but
those are considered performance and not critical, anyways if someone needs it
let me know.
More references:

My Old posta about how to monitor
Just browse the link, I also added description for each one of them.
They can be called by using check_by_ssh nrpe, snmp.

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