I have my suspicion that it is still used heavily inside Apple. It especially caters to programmers that are control freaks like me -- you are a little closer to the metal (pun intended).

It's not difficult to determine where different languages are used – you can run `symbols -noDemangling BINARY | grep _Z`, where BINARY is a path to any binary, and see how many symbols use Itanium C++ name mangling. You'll see it sprinkled in enough places to get an idea of which parts of the system use it more than others.

Of course, parts of the Objective-C runtime are written in Objective-C++, so someone more pedantic than I might claim that fact alone counts as it being "used heavily."