I killed a nice needlenose last weekend and decided to carry it home and try it out. Cleaning it was a pain but straightforward. Using tinsnips, I cut the "shell/exoskeleton" along the spine from the head to the tail. Once it was split, I simply skinned the shell free from the fish and filleted the meat off the spine and ribs EXACTLY like you would the backstrap from a deer.
Like I've heard from others, the meat was white, clean and free of bad smells or textures. As far as preparation, I found a salt brine recipe online and brined the meat for a couple of hours in the fridge. Looking back, I could probably have skipped this step because it did make the meat a bit saltier than I really wanted. After brining, I washed, dried, cut into 2" long chunks, breaded and fried the meat just like any other fish.
The consistency is a little chewy, more like a beef steak than the flaky meat you normally associate with fish, but it didn't take away from the edibility. The short of it is that it made a pretty good meal and I will most likely do it again.
If you've never tried it, you are missing out on some pretty decent table-fare.