Right, excuse me for being terse, but BigNath: I had the same problem, and it was caused by a bad install. - This module is very overide unfriendly, so don't install it in your overide folders! - Also, if the images are not in the right folder you will get a weird page layout during checkout.

steve1965: have you configured everything properly in your admin interface. - There are a lot of fiddly little details that need to be configured for this module and you MUST have everything in place or it won't work - it's that simple.