It is essentially a big pile of macros, so sometimes number of keywords that you have to keep in your head is staggering. Also, Elixir is a pretty big language - I knew Erlang before diving into it - so the barrier and number of concepts that you have to get familiar with is huge. Don't get me wrong - all these concepts/design patterns are necessary (I am thinking about BEAM and OTP here). Erlang (and therefore Elixir) is complete as development environment, that's where the amount of knowledge is coming from.
Cool intro to erlang/BEAM: http://www.slideshare.net/BrianTroutwine1/erlang-lfe-elixir-...