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

Blood and gore: The blood effects spurt in a thick, jelly-like consistency and in heavy amounts when you or an enemy is shot. Blood does linger, splatters onto walls, floors and the screen (when you or an enemy is shot close-up); gathers in puddles; and there is static blood splattered on walls and floors throughout. Bodies do linger, and you see many heavily bloodied, dismembered and overall disfigured human (some Locust) bodies throughout. There is gibbing, meaning when you shoot enemies with the shotgun, revolver, sniper rifle, turret or throw a frag grenade, enemy bodies will explode into large, bloody chunks (heads will split in half--squishing sounds on impact included--and explode in detail when shot by a sniper rifle, as the enemy stand frozen in their last living position; heavy amounts of blood gushing from their necks), with the remaining dismembered limbs, torsos and body parts lingering in detail.

Additionally, a main weapon has a chainsaw attached to the end, and if used, it will sever the enemy diagonally--if you attack from behind, you'll shove it in their lower back and then sever up to their skulls--through their torsos (showing entrails, flesh and bone), as heavy amounts of blood spurt out and splatter onto the screen--their dismembered bodies (which you can then kick around, as blood smears about) linger, grotesque details of their innards visible. When they're down but not dead, you can finish them by stomping on their head--resulting in a crushed, bloody mess; grab them off the floor and use them as a "meat-shield," as they then absorb the enemy bullets with bloody results--you'll snap their necks when finished; or take the Torque bow, wrap the string around their neck, and then kick to decapitate them.

However, all can be disabled by going into "Options," "Game Settings," and then turning "Gore" from "on" to "off". The blood will then be substituted for sparks, and gibbing--along with the bloody sounds--will be completely disabled in all offline and online modes, but only for gameplay and in-game cutscenes. Pre-existing blood on floors and walls, the many bloodied bodies and the bloody sounds in the in-game cutscenes will stay. Lastly, even with the "Gore" filter enabled, all blood and gore is still present during the entire chapter dubbed, "Intestinal Fortitude" (which is detailed in "Specific scenes" below); and all blood/gore remains in pre-recorded scenes that handle the more epic-scaled, non-gameplay sequences--but these scenes can be counted on one hand, are brief and contain very little gratuitous effects.

Specific scenes of blood & gore:

Intense violence: Six months after defeating the Locust General Raam and placing then detonating a Lightmass bomb at the Locusts' tunnels' heart, Marcus and his team succeeded in wiping out many of the Locust and completely destroying the legion known as Kryll; but they find that not only did the bomb release a gaseous and toxic form of liquid Imulsion into the atmosphere--causing what they call "Rustlung" in the remaining human forces--but much of the Locust Horde has survived, including their ever-elusive Locust Queen. The human COG (Coalition of Organized Governments) forces have begun to slowly discover this, as two of their more secure cities have been abruptly sunk by unknown Locust attacks, and you soon find out the remaining human stronghold, Jacinto, is being targeted for the same. Marcus and his team must deal with even greater resistance, as Dom searches for his captive wife, Maria, and Marcus uncovers dark secrets of his father's past, all the while they (once again) advance into Locust territory and try to foil the enemy's plan for Jacinto...

After you're introduced to a new COG recruit, there's the choice to give him basic training or get straight into the action. And the base gameplay consists of navigating through the vast, ruined environments, as you combat hordes of Locust, by vaulting over, sprinting to and taking cover with objects (downed cement pillars, burned out cars, etc.), while using your varied arsenal to pop out from behind cover and shoot the enemy down. You'll hold the area against Locust waves as Jack (your cloaked, hovering robot) cuts open doors or gathers intel; flank, take out and then use enemy turrets to dispatch incoming enemy waves; kick open doors, press buttons and turn valves/pull levers to activate lifts, open gates and pop-up retractable cover; and use your chainsaw to clear barricades. You'll also navigate a Rift Worm's insides while trying to sever its arteries with your chainsaw; drive a Centaur tank as you shoot down enemies and jump gaps; fight bosses like the aquatic Leviathan or Skorge, the Locust Queen's chainsaw staffed lackey; and pilot a Reaver in an on-rail sequence while shooting at and dodging Skorge's giant Reaver's jaws and missiles.

Your enemy consist of the Locusts--which closely resemble Orcs from the Lord of the Rings--their many types: Drones, Theron guards (smarter, faster versions of the Drones, often equipped with the deadly Torque bow), Kantus (tall, monk-like Locust that primarily use their powers to remotely revive downed Locust), Boomers (and their sub types; Grinders, Maulers and Flame--huge, slow and lumbering Locust equipped with Boomshot grenade launchers, Mulcher gattling guns, Boomshields and Scorcher Flamethrowers respectively), and Sires (mysterious, reject experiment; these Locust, human "hybrids" only appear once). And their more mindless lackeys; Tickers (quick, crawling trip mines), Wretches (small ape-like, hunch-backed Locust), Bloodmounts (large, two-legged creatures with Beast Rider Locust mounted to pilot them) Seeders (giant, ant-like creatures that shoot out Nemacyst; gooey, organic projectiles that explode on impact), Reavers (flying squid-like creatures the Locust ride) Corpsers (giant, multi-legged, insect-like Locust), and Brumaks (two-legged, three-story Locust with missile launchers strapped to their backs).

You'll be combating these varied enemies with the Lancer assault rifle (a chainsaw equipped at the end), Snub pistol, Longshot sniper rifle, Gnasher shotgun, Mulcher (a portable turret), Scorcher flamethrower, Mortar (launches missiles that fall from the sky), Hammer of Dawn (a satellite-guided laser; only used twice), Boomshot grenade launcher, Boltak revolver, Hammerburst assault rifle (an accurate, one-shot, long-range rifle), Gorgon Burst pistol (shoots multiple, short bursts) Torque Bow (shoots exploding arrow-like bolts), the Boomshield (used for portable cover), and grenades; Frag, Smoke (stuns enemies/clouds vision) and Ink (ejects choking gas).

The combat system is relatively strategic, but in turn, utterly chaotic and very violent, and consists of you using your varied arsenal to tear through the hundreds of enemy Locusts; Troika turrets, the Mulcher and Mortar to literally blow them to pieces; your chainsaw to sever them in half; grenades, the Boomshot, nearby explosive objects and flamethrower equipped enemies' punctured tanks to take out close-by Locusts (causing their bodies--parts--dust and debris to fly); the flamethrower to burn them alive (with their partially disintegrated corpses smoldering, as the remaining, glowing embers float in the air after the fact); the Torque Bow to impale them with large, arrow-like bolts, which then explode on impact; Ink grenades to choke them in thick, green clouds of gas; the Hammer of Dawn to incinerate enemies with a laser pillar from the sky; the butt of your weapons and the Boomshield to attack--or hit and pin grenades to--them in close quarters; and you can use the down but not dead Locust enemies as "meat shields" to absorb incoming enemy bullets--you'll snap their necks when you're done--or simply hit them while their down to finish them off.

When shot, enemy Locust will grunt in deep, grizzled tones, gurgle and then fly back and fall in contorted positions, either dying immediately or crawling around on their knees awaiting revival from their allies, only to be shortly stomped to death by you; but as they are hideous, mindless monsters, it isn't too impacting--there's not much sympathy to be had. Coupled with their monstrosity; overwhelming odds (your three to four against their dozens upon dozens); environments' semi-destrucable nature (wood breaks away; glass shatters; bullets imbed, melt, and then smolder in floors and walls; concrete objects gradually crumble with heavy gunfire or explosions, as pieces fly off in chunk and linger, with their steel underwire exposed, etc.); and their equally destroyed facades (cities are overturned and ripped apart; dirt, debris and tons of rubble litter the areas, with later cities sunk into the earth--insurmountable, multi-level ruins; entire buildings falling into sinkholes, as their ashes and lit embers fill the air), it gives the overall combat a tense, gritty and hostile feel.

And although you and your team are muscular, gun-toting men with massive chips on your shoulders--making you feel more empowered than the average survival/horror "victim"--the Locust can definitely hold their own, and since the environments are usually wide open, and for the fact that enemies can burrow from underground, you're never sure where they'll come from next. You'll at first hear a low, distant rumbling, with the enemy abruptly piling out of their emergence holes, grunting threats and taunts in deep, gravelly voices, as they put heavy fire on your position, and then try to trap you from all sides. Enemies will frequently shoot from the deadly Troika turrets at the other end of the area, as waves of them take cover, close in and flank you; Scorcher equipped enemies will attack in cramped quarters and let their blazing flames loose (if you puncture the tanks on their backs, they will try to rush you in a kamikaze attempt); and later enemies will either snipe you, use the Torque bow to shoot you from afar or the deadly Mortar weapon to barrage you with multiple missiles from the sky (which almost always kill you in one hit).

Enemy encounters only get worse the further you get in, with the more powerful enemies being introduced, mixed with the lesser; Tickers quickly skitter from holes in groups as they hiss/click, stop at your feet and detonate; Wretches abruptly rush you in droves and tear away at you with their claws (often as you deal with other enemies from a distance; Wretches and Tickers flush you out); Boomers (Grinders, Maulers and Flame) are huge, (thankfully) lumbering Locust, who use the Boomshot, Mulcher, Scorcher and Boomshield--with maces--as they bellow, "Boom!" (etc.), taking many more shots to down than an average Drone; resilient Reavers land on their tentacle legs, shooting missiles point-blank while trying to impale you with said legs (even when dead, they'll explode, killing you if you're too close); Bloodmounts gallop on two hulking arms, vault over cover and then rush you with two razor-sharp clawed legs, while their rider shoots away; and Kantus, tall, tough Locust that revive downed enemies and attack with powerful burst pistols and choking Ink grenades.

Because of the above enemies, the gameplay is an intensely suspenseful, non-stop, heart-pumping thrill-ride--often verging on horrific; you'll ride the giant, "Derrick" platformed carrier, as you gun down incoming Nemacyst projectiles and Behemoth Brumaks with a mounted turret, while dealing with Locust trying to grapple onto and hijack your vehicle; traverse through a mammoth Rift Worm's body as you dodge a regurgitated ball of rubble the size of a house, avoid deadly, shooting spouts of acid, navigate through its toxic, maze-like intestines before suffocation; and escape before you drown in a rising pool of its blood; you'll explore an abandoned secret facility while you dodge and disable it's security system, all the while dealing with hordes of incoming Wretches at the same time; and after inadvertently awaking the Sires from their sleep (grotesque, reject experiments with twisted flesh, and long, disconnected tubes sticking from their humped backs), they'll eerily pound at and quickly break from their vats, as they then rush you with their huge claws by the dozens--only stopping when the vast amounts of vats have been completely emptied.

And since you can't take more than a few hits from most enemies, if you don't take adequate cover from their fire in time, a small, red skull emblem will begin to gradually solidify in the middle of the screen, getting clearer the closer you get to death, as the screen fades and sound muffles all around--you'll then either crawl, and bleed out as you wait for an ally to revive you, or die. Your team is vulnerable to the same enemy fire, and when downed, they will fall and hunch helplessly to the floor as they bleed out, calling to be revived, forcing you to make it through enemy fire, or else lose their support. And as some of your cover is destructible, you're not always safe (or really ever for that matter); it's you and your three teammates against (dauntingly) the entire Locust horde--you're always on the offense.

The cutscenes contain fiery explosions and chaotic battles--with some allied vehicles crashing into flame; you see a few allied soldiers shot down by the enemy; there are frequently intense, often horrific situations involving the main characters; Locust end up taking human prisoners and torturing them, with you witnessing two of the brutal outcomes; and there are a couple of tragic main character deaths. When it comes to age, although there is an option to turn off the blood, gore and harsh language (sh*t and the f-word), these elements are still enabled in a handful of the pre-recorded cutscenes, the filters do not remove the static blood on floors and walls or the many bloodied bodies, and all gore is still present in the very grotesque, bloody "Intestinal Fortitude" chapter; it's filled with intensely violent gameplay and disturbing enemies verging on horrific; there are a couple of impacting scenes involving human torture; and there's still a considerable amount of language left intact--like the last, even with the gore and (now upped) language filter enabled, this still isn't really appropriate for younger teens; it's just more suited to older teens and adults.

Strong language: There are over five dozen uses of sh*t, over three dozen uses of hell, over two dozen uses of a**, over a dozen uses of d*mn and b*tch, under a dozen uses of God d*mn, the f-word and bastard, three or under uses of God, p*ss and SoB, and one use of "t*tties" (a main character refers to his vehicle's headlights as this). However--other than a few of the pre-recorded cutscenes, which still contain a couple uncensored uses of sh*t--if you enable the "Strong Language" filter, all uses of sh*t and the f-word will be censored in gameplay and in-game cutscenes.

Additionally, a few of the collectable--and optional--War Journals have nine uses of hell, two uses of d*mn, and one use of a**, bastard and God in their text. Other than the main script, allies will very rarely--I caught it once--call your character a "P*ssy" when reviving you; when being revived, your character will (I again, only caught this once) rarely say, "Now I'm p*ssed!"; your character will infrequently say, "D*mn it!," "Ah, sh*t!," and very rarely (I only caught this once too) "God d*mn son of a b*tch!" when his weapon jams; and your team will frequently use hell, sh*t and phrases like, "Back in your hole b*tch!" and, "Eat sh*t and die!" while fighting the Locust.