While there are some implementation differences (py-spy is written in rust, profiling.sampling is a mix of python and C etc), the end result seems pretty similar to me.

One thing to note is that there are some differences in blocking behaviour of the target process. Py-spy blocks by default and profiling.sampling doesn't. I wrote a bit about why py-spy blocks by default here https://www.benfrederickson.com/why-python-needs-paused-duri... - the first version of py-spy also didn't block and since we got incredibly misleading results at times this was one of the first changes I made to py-spy