The content is scalable, the edges will not be scaled, in typical usage.
They're generally used for backgrounds to buttons, or other screen decorations, where the scaled content can be scaled infinitely without losing resolution.
Ideally, they're used in addition to density-dependent resources where appropriate, so that the section of the resource (which you didn't explicitly state is scalable) isn't upscaled and subsequently pixelated.
Consider the splash screen for the Kindle app on Android, which features a silhouette of that boy reading against a tree. In a simplified version, the ground can be scaled horizontally infinitely, but if the boy was scaled, he'd appear skewed. So you could use a nine-patch and specify the section which can be scaled, and in which direction.
That's not enough though - if you only included a low resolution resource, the resource would still be scaled up initially if the device display was of a higher density. In this instance, the boy might look blurred from the upscaling, and is an example of when a higher resolution resource could have helped prevent the pixelation.
The way you've phrased the question suggests (to me) that you're asking whether 9-patch images can replace all drawable resources, like icons or resources with pictures in them, to which the answer is no. They're only to be used to scale sections of resources which feature a block of a single colour (i.e. sections which cannot be pixelated).
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http://developer.android.com/guide/topics/graphics/2d-graphics.html#nine-patch