[10] A sequel to Rambo III (1988), it is the fourth installment in the Rambo franchise and co-stars Julie Benz, Paul Schulze, Matthew Marsden, Graham McTavish, Rey Gallegos, Tim Kang, Jake La Botz, Maung Maung Khin, and Ken Howard.

In the film, Rambo (reprised by Stallone) leads a group of mercenaries into Burma to rescue Christian missionaries, who have been kidnapped by a local infantry unit.

Rambo was theatrically released in the United States by Lionsgate Films and the Weinstein Company on January 25, 2008, and in Germany by Warner Bros. Pictures on February 14, to mixed reviews, with praise aimed at Stallone’s direction and performance, action sequences, and musical score, but criticism for its plot, excessively graphic violence, and political commentary.

During the political protests of the Saffron Revolution in Burma, ruthless SPDC officer Major Pa Tee Tint leads his Burmese Army forces in a campaign of fear.

His soldiers pillage settlements, sadistically slaughter innocents, abduct teenage boys to be drafted, and hold women hostage to be raped as sex slaves.

Michael Burnett, a missionary doctor, attempts to hire Rambo to ferry his group up the Salween River into Burma on a humanitarian mission to provide medical aid to a village inhabited by the Karen people.

During the trip, the boat is stopped by pirates demanding Sarah in exchange for passage, forcing Rambo to kill them.

The missionaries arrive at the village but are attacked by Tint's forces, who take Sarah, Michael, and other survivors prisoner.

The pastor of the missionaries' church comes to Thailand and asks Rambo to lead a team of five mercenaries on a rescue mission.

Rambo takes the mercenaries to the drop-off point and offers to help, but Lewis, a former SAS soldier and the team's leader, refuses.

As they survey the damage, a squad of Tint's soldiers arrive in a truck with a group of prisoners, whom they proceed to torment.

Rambo joins the mercenaries, and they make their way to Tint's camp at night, where they stealthily rescue the rest of the surviving prisoners.

Before Tint can execute them, Rambo launches a surprise attack with an M2 Browning-equipped technical, allowing the mercenaries to escape and engage them.

In the aftermath, Rambo, inspired by Sarah's words, returns to the United States to visit his father at his home in Bowie, Arizona.

[14] Stallone had stated that part of the reason that it took so long to produce a fourth film was due to a lack of a compelling story that motivated him to return to the role.

[17] Stallone thought it was "good", however, he felt the idea lacked the "essence of Rambo", still wanting the character to be a "lost man wandering the world".

After some negative feedback from the online community, Stallone spoke with Harry Knowles[29] and said: Lionsgate jumped the gun on this.

[38] The extended cut premiered on Spike TV on July 11, 2010, two weeks before its Blu-ray debut and to commemorate Stallone's then-latest film The Expendables.

The Blu-ray features a 7.1 DTS-HD mix, and an 84-minute production diary titled "Rambo: To Hell and Back".

[42] The film was shown in Ireland and the United Kingdom by other theater chains such as Empire Cinemas, Vue, Cineworld and Ward Anderson.

The site's critical consensus reads: "Sylvester Stallone knows how to stage action sequences, but the movie's uneven pacing and excessive violence (even for the franchise) is more nauseating than entertaining.

Scott wrote, "Mr. Stallone is smart enough—or maybe dumb enough, though I tend to think not—to present the mythic dimensions of the character without apology or irony.

"[48] Michael H. Price of Fort Worth Business Press wrote, "Stallone invests the role with a realistic acceptance of the aging process, and with traces reminiscent of Humphrey Bogart in 1951's The African Queen and Clint Eastwood in 1992's Unforgiven — to say nothing of the influences that the original First Blood had absorbed from Marlon Brando in 1953's The Wild One and Tom Laughlin in 1971's Billy Jack.

It's spot-on in terms of how I imagined the character — angry, burned-out, and filled with self-disgust because Rambo hates what he is and yet knows it's the only thing he does well.

Upon release, the then-ruling military junta ordered DVD vendors in Burma not to distribute the film due to the movie's content.

Some rebels in Burma have even adopted dialogue from the movie (most notably "Live for nothing, or die for something") as rallying points and battle cries.