PDO and prepared statements are still kind of confusing to me, no matter how much I read about them so far. So I know they are more "secure" but is it really that important? I mean I can get the same end result using basic mysql with mysql_real_escape_string() and htmlspecialchars() right?
You could, but PDO and prepared statements are the absolute safest. Could you do it by hand and use the mysql_real_escape_string() function? Sure. In fact, your output might look identical. But in the end, the code that PDO would require would be a hell of a lot shorter than the code if you had done it manually.
Also, if you aren't using prepared statements, you run the risk of human error: say you forget to escape a value or sanitize an input. Mixed in with all of your other code, the one line that isn't properly sanitizing could crop up to be a nightmare down the road.