Hi, after my HDD crashed, re-installed windows and fallout. Also I upgraded video card to a EVGA GTX 570.
With the latest patch, the game wouldn't even start.
Any support?
Thanks.

sysinfo

OS Name Microsoft Windows 7 Ultimate
Version 6.1.7601 Service Pack 1 Build 7601
OS Manufacturer Microsoft Corporation
System Type x64-based PC
Processor Intel® Core™ i7 CPU 960 @ 3.20GHz, 3201 Mhz, 4 Core(s), 8 Logical Processor(s)
BIOS Version/Date American Megatrends Inc. 0607, 2/26/2010
SMBIOS Version 2.5
Hardware Abstraction Layer Version = "6.1.7601.17514"
Installed Physical Memory (RAM) 12.0 GB
Total Physical Memory 12.0 GB
Available Physical Memory 10.2 GB
Total Virtual Memory 24.0 GB
Available Virtual Memory 20.6 GB
Page File Space 12.0 GB
Page File C:\pagefile.sys

NVIDIA System Information report created on: 04/29/2011 08:20:08

[Display]
Operating System: Windows 7 Ultimate, 64-bit (Service Pack 1)
DirectX version: 11.0
GPU processor: GeForce GTX 570
Driver version: 267.24
DirectX support: 11
CUDA Cores: 480
Core clock: 797 MHz
Shader clock: 1594 MHz
Memory clock: 1950 MHz (3900 MHz data rate)
Memory interface: 320-bit
Total available graphics memory: 4095 MB
Dedicated video memory: 1280 MB GDDR5
System video memory: 0 MB
Shared system memory: 2815 MB
Video BIOS version: 70.10.17.00.74
IRQ: 24
Bus: PCI Express x16 Gen2

[Components]

nvui.dll 7.17.12.6658 NVIDIA User Experience Driver Component
nvxdsync.exe 7.17.12.6658 NVIDIA User Experience Driver Component
nvxdplcy.dll 7.17.12.6658 NVIDIA User Experience Driver Component
nvxdbat.dll 7.17.12.6658 NVIDIA User Experience Driver Component
nvxdapix.dll 7.17.12.6658 NVIDIA User Experience Driver Component
NVCPL.DLL 7.17.12.6658 NVIDIA Compatible Windows Vista Display driver, Version 266.58
nvCplUIR.dll 3.5.797.0 NVIDIA Control Panel
nvCplUI.exe 3.5.797.0 NVIDIA Control Panel
nvWSSR.dll 6.14.12.6658 NVIDIA Workstation Server
nvWSS.dll 6.14.12.6658 NVIDIA Workstation Server
nvViTvSR.dll 6.14.12.6658 NVIDIA Video Server
nvViTvS.dll 6.14.12.6658 NVIDIA Video Server
NVSTVIEW.EXE 7.17.12.6658 NVIDIA GeForce 3D Vision
NVSTTEST.EXE 7.17.12.6658 NVIDIA 3D Vision Test Application
NVSTRES.DLL 7.17.12.6658 NVIDIA 3D Vision Module (0)
nvDispSR.dll 6.14.12.6658 NVIDIA Display Server
NVMCTRAY.DLL 8.17.12.6658 NVIDIA Media Center Library
nvDispS.dll 6.14.12.6658 NVIDIA Display Server
PhysX 09.10.0514 NVIDIA PhysX
NVCUDA.DLL 8.17.12.6724 NVIDIA CUDA 3.2.1 driver
nvGameSR.dll 6.14.12.6658 NVIDIA 3D Settings Server
nvGameS.dll 6.14.12.6658 NVIDIA 3D Settings Server

Yes, you have to be patient, Bethesda struck again. Meaning they released another patch that broke the game and now we have to wait for them to "fix" it.

I am on Windows 7 Ultimate x64 and it works for me. (I can barely play it since the hardware on this laptop is crap) I use it to mod the game and then I convert my save back to 360.

It might be the service pack for W7 since I know of some things it has conflicts with. So try uninstalling SP1 and it should work.