Content review for this game:
Pertaining to the ESRB rating.

The game opens as protagonist, Niko, gets off a boat from Russia to America. He has been receiving letters from his cousin in America, that claim his cousin has plenty of cash, women, a fancy car, and a huge mansion. When Niko greets his cousin, he finds this not to be the case; his cousin lives in a dirty little apartment and taxi drives for a living—Niko is disappointed to say the least. At first, you can sense remorse in Niko's tone and behavior; he talks about the Russian wars, how he had to do bad things, and regrets it. In fact, a main reason Niko came to Liberty City was to have a clean start. But, as he progresses, Niko loses sight of that goal (or maybe never truly had it) and becomes a further corrupt, desensitized and plain unlikable person.

Blood effects: When you shoot, hit or run over an enemy, blood spurts in moderate amounts and splatters on nearby floors and walls. Blood also splatters on-screen and stains your clothes to show when Niko’s low on health—blood effects in cutscenes are quite a bit more pronounced. There is no option to turn blood off.

Physics: The game uses the NaturalMotion engine for its physics, originally meant to study the movements of humans and animals. Here's an excerpt from their site:

"Dynamic Motion Synthesis is NaturalMotion's proprietary technology for synthesizing animations on-the-fly. Previously, animation data had to be manually created (through key-framing) or recorded (through motion capture). This is expensive and laborious, and results in static non-interactive data. DMS is instead based on a full simulation of 3D character(s), including body, muscles and motor nervous system. This creates fully interactive animations that act and react differently every time."

In other words, when you kill an enemy he contorts in pain and struggles to get up in a convincing manner. Or when you drive over a person, their blood splatters on your windshield, as they fly through the air. Or just when you or other civilians run through the street, every reaction and movement looks/feels real; furthering your attachment to Grand Theft Auto's violent situations. The game's cars use the NaturalMotion engine also, and when you have collisions, paint scrapes off as individual parts tear and fall off, depending on how hard you hit. Cars can also explode, and if you hit things at the right speed, Niko will be flung out the front window onto the pavement—the physics engine has to be seen to be fully believed.

Driving: Becuase of the cities crowed nature, you will frequently have to drive around traffic by driving on sidewalks, in the wrong lane, and/or between lanes to get around efficiently. You can run into/over any car or person, as well as things like trashcans, mailboxes, lamp posts, fences, etc—creating mass damage. You can drive responsibly and even stop at toll booths to pay for travel across the bridges. But, this method will take much longer to get around, and even the most patient person will probably end up taking the easier route, which is the way of destruction, mentioned above (you can also drive motorcycles, boats and helicopters).

Carjacking: If you see a car in this game, you can drive it. For parked cars, Niko will try the door and see if it's unlocked (it won't be). He'll then look around to be sure no one's looking, and then smash the driver's side window, get in, hot-wire the car, and drive away. For cars with people in them, Niko will jerk the door open and either pull, beat, or if you have a gun, stick up the person inside and then throw them out of the car, leaving them on the pavement and vulnerable to traffic.

Police: When you are seen doing something criminal, cops will give chase, as a large pulsing circle shows up on your radar, representing the view area of cops. You'll then have to break their line of sight by driving out of the circle and waiting it out. If cops catch you, your hands will go up, the screen will fade to black, and you will appear in front of the police station. You'll then receive a message stating the cops took all your weapons and money as a bribe. However, cops in can sometimes seem to forget they are cops, and as long as you don’t kill/steal in front of them or attack them, you can run into objects cars, pedestrians, and they most often won’t do a thing.

Guns: There are many guns, including pistols, shotguns, sniper rifles, machine-guns, etc. You have the ability to take cover behind any object, and you can either blind fire or pop out from cover, lock onto your target and shoot. As soon as you aquire a gun, you can literally kill anyone on the street—old women, hobos, police, people in cars, everyone—and because of the physics engine, after shooting people, they'll twitch and react after being shot; it takes them a while to die. If they're injured, they will slowly and painfully get up and try to crawl to safety, as you then finish them off by riddling them with more bullets—gunplay is convincing and brutal.

Combat: You have the ability to shove, punch and kick at anytime, and you can beat anyone on the street to death if you so choose. Also, often if you run out in front of a car, or just bug someone on the street, they themselves will start a fistfight then and there—even if you run, they will surprisingly chase you for quite a distance.

Missions: Niko basically start out as a taxi driver. But soon becomes more entangled in the city's crime life, and from there on out, will be helping people aquire drugs, kill for money, and later in, rob a bank, kill countless police and even a few swat teams. Almost every mission consists of Niko killing and stealing for little to no good reason, and the game gives you no real moral choices.

Content review posted: 05/09/08