How do I choose between Semaphore and SemaphoreSlim?

One difference is that SemaphoreSlim does not permit named semaphores, which can be system-wide. This would mean that a SemaphoreSlim could not be used for cross-process synchronization.

The MSDN documentation also indicates that SemSlim should be used when "wait times are expected to be very short". That would usually dovetail nicely with the idea that the slim version is more lightweight for most of the trade offs.

SemaphoreSlim is based on SpinWait and Monitor, so the thread that waits to acquire the lock is burning CPU cycles for some time in hope to acquire the lock prior to yielding to another thread. If that does not happen, then the threads lets the systems to switch context and tries again (by burning some CPU cycles) once the OS schedules that thread again. With long waits this pattern can burn through a substantial amount of CPU cycles. So the best case scenario for such implementation is when most of the time there is no wait time and you can almost instantly acquire the lock.

Semaphore relies on the implementation in OS kernel, so every time when you acquire the lock, you spend quite a lot of CPU cycles, but after that the thread simply sleeps for as long as necessary to get the lock.

The MSDN documentation describes the difference.

In one sentence:

• The SemaphoreSlim class represents a lightweight, fast semaphore that can be used for waiting within a single process when wait times are expected to be very short.