In addition, the game also features non-shooting segments, such as defeating an enemy in hand-to-hand combat, sneaking past enemies without being spotted, and shooting targeted areas without missing. Some enemies attack Rambo with grenades or rockets, which can be shot and destroyed in mid-air.

Each level consists of the player shooting down waves after waves of enemy soldiers if the player waits too long to kill an enemy, the enemy will attack and the player will lose one of their lives. Trautman, from an enemy prison (also from Rambo III). The first and final levels are based on the desert battle from Rambo III, the second and third levels focus on Rambo rescuing the prisoners from Rambo: First Blood Part II, and the fourth level consists of Rambo rescuing his mentor, Col. The player assumes the role of John Rambo, fighting through five levels. The game is based on Rambo: First Blood Part II (1985) and Rambo III (1988), but not First Blood (1982). Rambo is a light gun shooter developed by Sega for the arcades in 2008.

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