I got this game when it came out weeks ago, and I must say that this is one of the greatest games I have personally played, and most certainly the best I have played this year, no small feat when games like GTA IV and metal gear solid were released. It has gotten decent to great reviews from video game websites.
I actually did not want to buy this when I first heard about it as it was called an RPG game. I do not like role playing games, as I am a first person shooter fanatic. That said this game plays more like a first person shooter with role playing game elements including the ability to upgrade your various skill sets. The combat system (called VATS, which automatically targets bodyparts) is brilliant. The story is also great, on the surface it appears to be a simple case of trying to find someone, but then it becomes much bigger than that in the overall scheme of things. The map is HUGE, I have literally been playing 3 weeks nonstop, averaging about 4-6 hours a night, and I still haven't discovered all the small towns and buildings. There are tons of side quests that are great too.
The coolest thing about this game is the karma system where depending on your actions you become a good person with good karma or an evil one with bad karma (like the ultimate 'choose your own adventure'). I for some reason cannot be a bad person even in the video game realm, so I have been doing mostly good things, like freeing slaves, killing slave holders (including massacreing an entire slaver colony, paradise falls), and helping anyone I come across. The downside is that a hit squad continually pops up from time to time to try and kill me.
All in all a fabulous game, so good that it makes me forget the 20 times this game has already frozen on me (for my PS3).