The subject pretty much says it all. I added an appointment in Outlook 2010, clicked the refresh iCloud button, but the appointment didn't show up on my iPhone4 Reminders until I synced with iTunes.
I have this working on my 4S and it works extremely well. You do not have to have iTunes opened at all. It is done completely with Outlook and iCloud wirelessly.
Let me walk you through the process of setting up since I'm not sure what/how you're setup now. These are the exact steps I used to get it working perfectly on my 4S.
Go to
iCloud Control Panel for Windows and download on your PC the iCloud Control Panel for Windows.
Then on your PC go to Control Panel> Network and Internet> iCould
Sign in using your iCloud ID if not already signed in, then put a check mark in the box for Calenders & Task with Outlook. <--This will install the Refresh iCould button on your Outlook Calender ribbon on the 'Home Tab' .
On your iPhone go to Settings>iCloud and be sure your account is the correct ID, also be sure that Calenders is turned to on (slide from Off to On)
Open iTunes and connect your iPhone. Go to the Summary tab and scroll down to the 'Options' box. Place a check mark in the box in front of "Sync with this iPhone over Wi-Fi".
Eject your iPhone and close iTunes and restart your PC.
On your iPhone hold down the on/off button until it reads "Slide to power off" your phone will show a scrolling icon then power off. After it finishes powering down restart your phone by holding down the on/off button until the Apple logo comes up on your screen.
On your PC open Outlook go to Calender then add a new appointment. The go to the Home Tab ribbon at the top and hit Refresh iCloud
Your iphone must have a wireless connection. You can open Calender on your iPhone and watch it refresh and add the new appointment to your phone.
Like I said, these are the exact steps I used to get it working on my phone. It works great sending appointments from your Outlook program to your iPhone Calender. Very painless and trouble free.
As a side note, once setup, when you open iTunes it will now sync automatically with your iPhone without being connected with the USB cord.