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The game features both first-person and third-person perspectives and the player can change to either perspective during gameplay. Main character creation occurs as the player experiences the character’s childhood. As a child in the Vault, the character receives a book titled “You’re SPECIAL,” whereupon the player can set the character’s seven primary aptitudes. The character receives weapons training and a PIP-Boy 3000 later on during childhood, and the player’s performance in various tests determines the rest of the attributes. Additionally, several quests inside the Vault influence the player character’s relationship with his or her father. Skills and Perks are similar to those in previous games: the player chooses three Tag Skills out of a total of 14 to be the character’s specialties. The maximum level the player can achieve is level 20. The Traits from the previous Fallout installments, slightly modified, were combined with Perks in Fallout 3, and the player can choose a new Perk each time after gaining a level.

The Vault-Tec Assisted Targeting System, or VATS, play an important part in the fighting phases of the game. While using VATS, real-time combat is paused creating a combat system that the Bethesda developers have described as a hybrid between turn-based and real-time combat. Various actions cost action points, limiting the actions of each combatant during a turn, and both the player and enemies can target specific body areas for attacks to inflict specific injuries. The game features a new health and radiation system as well. The player can measure an object’s radioactivity and gauge the effect it will have on the character.

Another game mechanic is that firearms wear out over time: as a weapon degenerates, its rate of fire slows and it loses accuracy. However, worn out firearms can be used to repair a similar weapon, or to make more reliable and powerful weapons. Weapon schematics can also be found and used to create various devices such as the Rock-it Launcher, created by combining a leaf blower and a wood chipper, that can fire various items such as lunchboxes and stuffed animals, or the Clever Shrapnel Bomb, made out of a Vault-Tec lunchbox and bottlecaps. Along with equipping various weapons, the player can also utilize different armors and clothing that may have effects that can alter various skills. For example, a pair of mechanic’s coveralls may boost the player’s repair skill while it is worn. Armor and clothing come in two main parts for the head and body, allowing a player to wear different combinations of hats and armor. Also, a player’s inventory has a specified weight limit, preventing a player from carrying too many items. Some items like weapon ammo have no weight, due to the developer not wishing to bog down inventory management.