- Awesome Music:
- The teaser trailer is set to a remix of Lil Nas X's "Old Town Road".
- The Doors' "Five to One" as Rambo mops the floor with the Human Traffickers in the tunnel.
- "Battle Adagio" makes its return in the final scene, and is still an effective Tear Jerker like it was in the previous movie.
- Big-Lipped Alligator Moment: The deleted opening sequence (and, in fact, the unrated version's sole difference from the theatrical cut), where Rambo attempts to rescue some people trapped by a landslide. It's not necessarily weird, but it is completely disconnected from the rest of the movie and never comes up again at any point in the film.
- Broken Base: Which version is preferred, the shorter theatrical cut or the extended cut? Not helping much is that the former was the only one shown in theaters in the U.S., U.K., and Canada and the only one to get a physical copy, while the latter is international and is only exclusive to Prime Video and Apple TV+.
- Catharsis Factor: Pretty much everyone that Rambo interrogates and kills over the course of the movie, especially when Hugo takes the fight to Rambo with a group of men and they all find out the hard way what an R-rated version of Home Alone is like.note
- Complete Monster: The icy Hugo Martinez and his savage, sadistic brother Victor are a pair of pimps seeking to join the much greater Human Trafficking operation of Don Miguel. Kidnapping numerous young girls, the women are beaten, raped and terrorized into the sex trade, kept as slaves until they are used up and disposed of, often addicted to drugs to keep them pliant and dependent. Abducting Rambo's honorary niece Gabriela, Hugo tells Rambo he will keep him alive so Rambo can suffer in the knowledge of Gabriela's fate, before Victor drugs her with heroin and the two send her to a brothel to be raped and abused, with her eventually dying. Seeking to make their fortune by trafficking countless women into sex slavery, the two stand as some of the vilest John Rambo has ever faced.
- Contested Sequel: Among moviegoers, the movie is either a satisfying and action-packed killfest that serves as a great finale to the Rambo franchise, an entertaining film but not as good as Rambo IV nor the great sendoff that a legend like John Rambo deserved, or a terrible movie that lacks character and substance and should have ended with the last film. Fans are also divided on whether the film's similarities to Taken, Home Alone, and Man on Fire are a good or bad thing.
- Critical Dissonance: Similar to previous entries, critics largely panned it while fans of the series were understandably far more positive.
- Fan Nickname: Some fans have nicknamed Hugo Martinez "the Mexican Jon Snow" because of his Celebrity Resemblance to Kit Harington.
- Fanon Discontinuity: Some fans pretend that the franchise ended with the previous one, since this one ended with Rambo losing his adoptive daughter and later his home to Human Traffickers, and finds himself once again Walking the Earth after killing them in a Roaring Rampage of Revenge.
- Hilarious in Hindsight:
- Some had compared the climax to that of Home Alone due to Rambo booby trapping his ranch to kill the villains. Ctrl Shift Face later did a deepfake video called Home Stallone, featuring Stallone’s face edited over that of Kevin McCallister.
- At the end of the movie, Rambo kills Hugo Martinez by ripping his heart out, Mortal Kombat style. In October 2020, Rambo has been announced as a downloadable Guest Fighter for Mortal Kombat 11.
- Some fans noted the similarities between this movie and Taken due to the human trafficking plot. Come 2021, Liam Neeson did The Marksman, which involved a retired Marine taking on a Mexican cartel and saving a young child in the process. The Big Bad of the movie even had a brother who is killed by the protagonist and the final showdown takes place in a barn, just like Last Blood.
- In this movie, Sergio Peris-Mencheta is the Big Bad and Óscar Jaenada is The Dragon. In the Spanish Netflix movie Xtreme, not only are they both villains again, but their roles are reversed, with Jaenada playing the Big Bad and Peris-Mencheta playing The Dragon.
- Adriana Barraza, who played Rambo's friend Maria, would later go on to portray a full-blown Action Girl in Blue Beetle (2023), complete with her literally going Rambo in the climax of the movie.
- Like You Would Really Do It: You didn’t think they would really kill off Rambo, would they?
- Moral Event Horizon: Hugo vowing to abuse and drug Gabriela out of spite against Rambo after having his men beat Rambo to near death and fulfilling that vow.
- Older Than They Think: Contrary to what many critics believe, the idea of Rambo fighting against sex traffickers near the U.S.-Mexico border and saving a girl from them wasn't inspired by the politics of the late '10s. It actually dates back to 2009, shortly after filming for Rambo IV wrapped up.
- Overshadowed by Controversy: Critics quickly picked up on the optics of Rambo battling Mexican cartel members, to the point that most "legitimate" criticism from published reviewers centered largely around the movie's perceived racism rather than its actual qualities and flaws from a storytelling and filmmaking standpoint (even though drug-running and human-trafficking cartels are most certainly not beloved in their home country, and many Mexican viewers enjoyed the film precisely because it cast cartel members as the villains).
- Signature Scene: Hugo's raid on Rambo's ranch, and the shootout in the tunnels.
- Too Bleak, Stopped Caring: A major reason why some Rambo fans consider it an example of a Contested Sequel. The last film ended with a high note as Rambo returns home to find peace. Here, it's completely destroyed as a cartel kidnaps and ends up killing his honorary niece and he is reset back to stage 1 as an outcast once more.
- The Woobie: Gabriela. She goes to Mexico to find her Disappeared Dad, only for him to tell her in no uncertain terms that he left simply because he never loved her and her mother and that he never wants to see her again. Then it turns out that Gabriela's "friend" used her dad's contact info to lure her down to Mexico in order to sell her to Human Traffickers. When Rambo's first attempt to rescue her fails, her captors show her proof of it, carve an "X" into her face, and single her out for exceptional cruelty just to spit on the man who stood up to them. By the time she's finally rescued, she's been enslaved in a brothel for most of a week and pumped full of drugs to keep her subdued, leaving her just lucid enough to break down in fear at the slightest human touch. Then, as a final Gut Punch, she dies of an overdose from the forced drug use as Rambo is driving her home.
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