Actually, Visual Studio isn't necessary -- not even the Microsoft SDK. The Qt SDK comes with Mingw32 out of the box, and that's also the default option for the kde emerge system, which basically builds all the dependent libraries, from libjpeg to openexr, from lcms to libz. It has the advantage of not needing the weird set of C-libraries that you get with each new msvc version, but the disadvantage that apps start much slower.