It alows you to make a configuration for a specific game and save it as an icon within epsxecutor. This way when you click an Icon it launches the desired game with the config and with your selected memory cards. Its great when you have a few games and don't want to reconfigure every time you switch to a new game. As already stated it also allows for easy mem card creation and allows you to toggle mdecs on/off. for more info read the readme. Now go get it. Its a small file to download. Get it here
http://www.psxemu.com/epsxe-download.shtml