Attachment Storage Type 
vBulletin allows you the choice of storing attachments in either your database or in your file system. You are able to change your storage method at any time by navigating to Attachments->Attachment Storage Type.

There are several factors you need to consider before choosing which method you wish to use. By default, vBulletin stores attachments in the database since every server that supports vBulletin will work with this method. Not every server will be able to store attachments in the file system.

Storing in Database:Storing in File system:
Brad 20th Apr 2005, 11:03am
If you store attachments in the database and your attachment table is larger then 200 mb is may be time to explore storing the attachments in the file system.

Attachments as files seems to be the faster option of the two when you are dealing with a large number of attachemnts.
Ben 20th Oct 2009, 10:50am
I changed the way the files are stored but when a new attachment is uploaded it is still stored in the database. A new file however is created in the selected directory.

Seems strange.

Staff comment: Actually that is not correct. The attachment itself is stored in the file system. Only the attachment info is stored in the database (size, post ID, user ID, etc.)
lemonadesoda 02nd Feb 2010, 02:28pm
I am using the filesystem storage type, in a folder not under the webroot. For workflow reasons, I have hundreds of scans (network scanner producing searchable PDF files) being sent directly to this folder. How to I "link" to one of these files in a post without going through a manual "upload" process?