skywise

As the subject says, I'm about to buy a newish 2010 HS from our local Lexus dealer.
What sorts of things should I ask about?
Things like factory settings, recalls, nav system update.
Anything I'm missing?

rajeev6

The 2010 models came in Base and Premium - this should be the first question.
I have the Premium - things to look for in it would be the display in center console (shows more information that a normal person would care for - but then I'm not normal ). It also shows view from rearview camera.
Rain sensing wipers - awesome
Mine came with some wood finish (not on dash and not on steering wheel) - not sure if this was normal.
Remote starter - was standard in Premium.
You may want to negotiate and get the dealer give you latest map update. Also, have Sat radio subscription thrown in for free - I think for at least 3 months on used cars.
LED headlights, ML audio, headsup display - I think these were all extras.
That's all I can think of at this time.

RJQMAN

I have a 2010 and a 2011 HS250H and I agree with Rajeev6 - here are my suggestions, which mostly echo his;

1) Try and get the dealer to throw in an update on the Navigation system, if the car has Navigation. A complete update in my area costs $160 and must be done by the dealer.
2) If it is a 'premium' it will have Rain sensing wipers, radar cruise control, heads-up display, and lane keep assist as well as cameras front and rear. The car either has these things or it don't. They are wonderful technical items. The wood grain Rajeev6 has was probably an after-market option - not sure how much wood grain the car has.
3) I have remote start on one of my cars and never use it. It is questionable, in my view, as it takes a special sequence of button pushes on the remote to actuate it, and then the car has to be restarted again when you get in it. It would seem of most value if the car is parked outside your home or office in a very cold climate, and you want to run the defroster and melt snow and ice before getting in. I think this is a dealer option - not sure - but I do know I have seen after-market remote starters for this car, some a little more practical than the Lexus version, if that is something you want.
4) The Serius Radio for a year or more is worth the money, in my opinion - again it may be worth more or less depending on where you live and how good standard radio reception is. I do not have the upgraded radio in either of my cars, but the reception on both AM and FM is much better than on any car that I have owned previously. The Sat radio is most valuable to me when I am on a trip, as you do not have to worry about drop-outs when you are just getting interested in a specific channel. However, it does not offer some of the shows that I like to listen to - it does have similar alternatives though. The dealer can, I think, arrange for up to a year of service if he wants to.
5) The swivel headlights either are on the car or they are not. Mine does not have the fancy ones - wish it did, because it would help when turning a corner at night in an unfamiliar area. They cannot be dealer added.
6) The dealer can change out the wheels if you want him to. I had chrome wheels added to both of mine, but I have also seen some black ones and other styles that could appeal if you like them. It cost me about $1500 to have the wheels changed out to Lexus Chrome Wheels - you could negotiate a better price perhaps, if you wanted to do something like that.

Hope this info helps.