While Aquamacs is a viable choice, from what I understand Aquamacs is not fully compatible with the Gnu Emacs settings and I was advised by people I trust that Emacs.app was a safer bet. I tried Aquamacs anyways but can't say I liked it very much. Emacs.app with @technomancy's Emacs starter kit made things pretty easy.
I also tried Emacs.app and Aquamacs. Aquamac's behavior was totally odd & didn't match any of the documentation. I found the Cocca Emacs.app to be much easier to set up and get running. That said, neither of them feel as good as MacVim, as far as native Mac apps go.
The one that drives me really crazy is that on Lion, both Emacs freak out if you try to resize from from anywhere except the bottom right corner. Similar issues with the green (+) button; full screen mode, etc.
Also, since you'll probably remap cmd to meta, you lose some system shortcuts which can be convenient when switching back and forth between various apps and your brain can't keep all the shortcuts straight.
http://jaydonnell.com/blog/2011/10/07/setting-up-aquamacs-fo...
The steps are pretty much the same for regular emacs, you just need to put things in ~/.emacs.d/ instead of ~/Library/Preferences/Aquamacs\ Emacs/