[b] Initially set in the year 2102, players control a resident of Vault 76 who must venture out into the dilapidated open world known as "Appalachia" in order to re-colonize the region and uncover a mysterious plague that has killed off its inhabitants.

Fallout 76 was released to generally mixed reviews, with criticism for the game's technical issues, overall design, lack of gameplay purpose, and initial absence of human non-playable characters.

[3]: 10  Set in the Appalachian region of West Virginia, the player controls a character who leaves a fallout shelter 25 years after a nuclear war left much of the United States decimated.

[10] The map replicates many real locations from West Virginia, such as the cities of Charleston and Morgantown, as well as landmarks like The Greenbrier resort and New River Gorge Bridge.

[10] The device serves as a menu, and allows the player to access items they have acquired, view detailed character statistics and active quests, and look at the map.

This relationship with the plague elevates a single Scorchbeast to the role of Queen, making it far larger and more dangerous, and allowing it to lead the legions of humans and animals in Appalachia through the use of a hivemind.

They discover that Vault 79 holds the entirety of the United States' gold reserve, transferred there from Fort Knox for safe-keeping in the event of nuclear war, and is well-protected by a series of security defenses.

This bullion is to be used to re-establish a gold backed currency all across America, though depending on the player's choices and greed, it could spell immense recession and strife across the region, pitting the Settlers and Raiders against each other in a battle for total conquest, and returning Appalachia to the turmoil it just broke free from.

However, despite losing most of the initial group to Raider attacks on the way across the devastated United States, Paladin Rahmani, Scribe Valdez, and Knight Shin make it to Appalachia, and using the fortified ATLAS Observatory as their new base of operations, renaming it Fort Atlas, they begin to rebuild the Brotherhood's presence in the region, all while dealing with gaining the alliance and friendship of the Settlers of Foundation, and the hostility of the Raiders at the Crater, with being supported by the residents of Vault 76 with securing munitions and other resources to help protect everyone in the region from the continued threat of the Scorched and Scorchbeasts.

By the year 2104, things have been going well in the Appalachian Wasteland thanks to the residents of Vault 76 and their continued support of both the Settlers in Foundation, and the Raiders in Crater, but the Brotherhood of Steel First Expeditionary Force that arrived some time ago is still splintered because of hostilities between Paladin Rahmani and Knight Shin over their primary objective, not helped by the continued attacks by Super Mutants and other threats that were released by the Enclave before they were wiped out in the years before Vault 76 opened.

[21] The Creation Engine proved difficult to work with, as it was still using code written for The Elder Scrolls III: Morrowind in 2002, and any part of the map the player was not currently in would not be loaded.

[22] The last two Fallout games developed by Bethesda were set in major cities along the East Coast of the United States, and the team wanted to instead explore a more rural location that would not have been targeted by nuclear warfare.

[23] In a 2022 retrospective article published by Kotaku, anonymous developers stated that nearly everyone at BattleCry disliked the decision to not include human NPCs, although Howard was insistent on their exclusion until after the game released.

[24] The free-to-play Fallout Shelter had grossed over $100 million in four years, and as a result, Bethesda took a greater interest in games that could continuously generate revenue after their release.

[32] In Australia, a free Fallout 76 vinyl containing the cover of "Take Me Home, Country Roads" was included as a promotion with the December 2018 issue of Stack magazine, available at retailer JB Hi-Fi.

[33][self-published source] Beyond the launch of Fallout 76, the game continued to receive further development support from Bethesda to improve or alter its design, combat technical issues, and take action against users seen as cheating.

[34] In December 2018, the prices of Fallout 76's in-game cosmetics received increasingly negative attention from players for being too expensive, particularly in regards to items added for the 2018 holiday season.

Eurogamer noted how a set of Santa Claus outfits and a large sign cost $20 and $14 worth of in-game currency (called Atoms), respectively, with players arguing similar pricing was enough to buy Fallout 4's season pass with all add-ons.

[35] In the spring and summer of 2019, the game introduced items that managed a player's surplus inventory and improved the quality of their weapons, both of which could be acquired through spending Atoms.

Many of these players found that their accounts had been closed without warning, and were emailed by Bethesda asking them to write an essay explaining why cheating and using mod software was damaging to online video games.

While Bethesda took action to combat these, many users called on the publisher to implement more rigorous anti-cheat protection for the game and to be more forceful in banning the accounts of those caught hacking.

It also introduces new content such as a box allowing unlimited storage for crafting materials, a placeable fast travel system with supplementary supplies, 1650 atoms per month, and exclusive cosmetic items.

[60][62][61] The numerous negative reviews from critics led Forbes to describe the release of Fallout 76 as a "historically bad launch" and to question if Bethesda would consider the property "worth saving" moving forward.

[63][self-published source] The Guardian called the game "a pointless walk in the post-apocalypse" featuring "half-baked conflict and witless quests to unearth the dead".

[64][self-published source] Eurogamer described the game as a "bizarre, boring, broken mess", adding that, shortly after its launch, it should be considered as a "failed experiment".

[65] Business Insider described Fallout 76 as "a jumble of disparate video game elements set loose in an online world, held together by a string of pointless fetch quests and experience points".

GameSpot said that "without having any of those people present to tell their stories personally, [Fallout 76]'s world is limited to being little more than just an environmental exhibit with things to kill", and that "there are no strong emotional anchors to help you become truly invested...".

[68] Many reviewers noted a large number of bugs and glitches present in Fallout 76, affecting numerous aspects of the game, as well as stability, performance and graphical issues.

Responding to customer complaints, Bethesda claimed that the bag had to be changed due to unavailability of materials, and initially stated the intention to take no action.

[114][115][self-published source][116] In a statement given to Ars Technica, Bethesda said that the breach occurred via "an error with our customer support website" and that they are "investigating the incident and will provide additional updates as we learn more".