So I started playing Neverwinter Nights 1 and I realized when I turn VSync on my framerate caps at 50 and I can't get it to hit 60 no matter what I have tried... I have 2 NVIDIA GTX 660's in SLI and I tried all the VSync options available plus some combinations of them and the in-game VSync option with no good result.. I also checked the nwn.ini and it's properly set to 60 for the VSync setting.. any ideas why I am capped to 50?

No idea as such, but if you're getting 50fps you can consider yourself pretty lucky.
The framerates are all over the place no matter the setup.

Agreed - and it's principally an Nvidia Forceware issue (see this thread for more info). I get framerates in the high 40s using a pair of 580GTXs and Forceware 310.70.

Enabling triple buffering may help framerates (it stores an extra frame to reduce the likelihood of the monitor having to redisplay an old frame with VSync enabled, at the cost of higher video memory usage) but I suspect this is more a driver issue. Older ones (refer to the Nvidia forum thread for the exact version) should offer better performance in NWN1 but at the cost of newer games.

Another possibility is if you are running at super-high resolutions (e.g. 3,840x2,160) which can't manage 60Hz due to DisplayPort/DVI bandwidth limitations.

Yeah, I suppose there is some truth in that.. I tried triple buffering on and off, neither made a change.. I am trying to run the game in my monitor's native resolution of 1920x1080 using HDMI so I don't think I have bandwidth limitations.. I did manage to reach 60 FPS but I still have screen tearing.. this is driving me insane! Also, I have no problem with reaching high frames per second in the game engine.. even with 16x AF, 32xQ AA, and 16x Transparency AA I still get upwards of 250+ FPS... It's just the screen tearing that is causing me headaches.

*UPDATE*
I did more tinkering and realized that VSync works for every resolution I have except 1920x1080.. for some reason VSync just doesn't work in the game with that resolution.. I guess I'll just play using the next resolution down from that.. Thanks for the help everyone =)