20 years after the fighting in Afghanistan from Rambo III, Pa Tee Tint (Maung Maung Khin) leads an army of Tatmadaw soldiers to pillage small villages in a campaign of fear. To him, watching innocent villagers forced into a field laced with landmines is fun, he orders his men to abduct young men to force into his army. U.S. Army soldier John Rambo (Sylvester Stallone) now lives in Thailand in a remote village near the Burmese border where he makes a living capturing snakes and taxiing people up/down the Salween River in his boat. One day, he is approached by a missionary named Michael Burnett (Paul Schulze) who says he needs help, he says that he and his group have to be ferried into Burma on a humanitarian mission to provide aid to Karen tribespeople. Rambo refuses, claiming that without weapons, there will be no changes, but he is eventually convinced by the other missionary Sarah Miller (Julie Benz).
During their trip, the boat is stopped by river pirates who demand an exchange- Sarah for passage. After negotiations, Rambo kills the pirates and burns their bodies to conceal the evidence. Michael is greatly disturbed at Rambo's actions, when they arrive in Burma he says the group will travel by road and not need him for the return trip. Everything goes fine until Major Tint and his army attack the village, slaughtering many, including some of the missionaries, and kidnapping the rest, including Sarah and Michael. When they fail to return after 10 days, their pastor (Ken Howard) comes to ask Rambo's help in guiding a team of 5 mercenaries to help find them.
Did You Know?
-Maung Maung Khin, who played Tint, fought for the real Karen rebels in real life. He was afraid if he took the role his family would be killed.
-This is the first Rambo movie to show Rambo with a shirt on at all times. In the other ones, he was always shirtless, but the reason he was not shirtless in this one is he was getting extensive tattoo work on both shoulders which he started getting in late July 2007
- Sylvester Stallone as John Rambo
- Julie Benz as Sarah Miller
- Matthew Marsden as School Boy, a young British sniper
- Graham McTavish as Lewis
- Tim Kang as En-Joo
- Reynaldo Gallegos as Diaz
- Jake La Botz as Reese
- Maung Maung Khin as Tint
- Paul Schulze as Michael Burnett
- Cameron Pearson as Jeff - Missionary #4
- Thomas Peterson as Dentist - Missionary #2
- Tony Skarberg as Videographer - Missionary #3
- James Wearing Smith as Preacher - Missionary #5
- Kasikorn Niyompattana as Snake Hunter #2
- Jordan T as Snake Hunter #1
- Supakorn "Tok" Kitsuwon as Myint
- Aung Aay Noi as Lt. Aye
- Ken Howard as Rev. Arthur Marsh
- Aung Theng as Pirate Leader
- Pornpop "Tor" Kampusiri as Snake Village Owner
- Wasawat Panyarat as Snake Village MC
- Kammul Kawtep as Snake Village Young Charmer