Bethesda's best product since Morrowind.
The combat in this game is...experimental, and in my opinion is very innovative and well worth the risk taken by Bethesda. Real time firefights and brawls meld well with the V.A.T.S's cinematic approach to a number game. If you don't like the odds of getting a headshot with that Mauser of yours in V.A.T.S, feel free to take the shot in real time. Fallout's body part damage system is the real jewel, however, and adds a sense of realism and opens up several options not available in your average RPG or shooter. I once suffered the effects of a concussion in-game; my vision blurred and I took a hit to my "perception" stat.
What gives this game the common misnomer of "Oblivion with guns" is the common texture usage. The faces look and are animated the same, that rock over there in the distance could've been teleported straight from Cyrodil for all we know, and there's a distinct similarity in the music. Nonetheless Bethesda has learned from it's mistakes and made the correct adjustments to birth a stellar game. The impassioned appeals of President Eden punctuated by the fissionable material in a nearby car cooking off after a brutal firefight definitely puts a bullet to whatever beliefs you may have about the similarity of Fallout 3 and Oblivion.
Overall, this game is a must play for PC gamers and Xbox 360 fans alike. It's immersive, challenging, humorous at times and dark during others, and overall built well. PC users may have a problem with Fallout 3 crashing randomly and a framerate drop when using V.A.T.S, but I believe this can be fixed in upcoming patches. If not, it's nothing to regret spending $50.00 over.