You're probably running Windows 7 too and you come here to find out that OS is not supported. Well believe it or not, FO3 runs perfectly fine under Windows 7.... Windows 7 isn't the problem. The problem is your CPU! No, there is nothing wrong with your CPU but there is something wrong with the way the game utilizes multiple threads and the way that ANY version of Windows assigns them to cores in the background. This causes the freezing. It will also happen in Vista and XP if you have more than 2 cores. Core 2 users will not experience the freeze (unless it's a Core 2 Quad) but Phenom X3 users and anybody else with multiple cores (or dual core CPUs with hyperthreading like Core i5s have) will get the freeze. This has been a known issue since the game came out and I think it even effects New Vegas (except it CTD instead of freezes)
Note this will only work if your OS shows 4 or more CPUs (virtual or physical, doesn't matter)
So try this,
Make a shortcut to FO3 by going to the games folder and right-clicking the exe file and selecting create shortcut. It will likely place it on your desktop which is fine. Right click the shortcut and select properties. Replace the 'target' with the following:
C:\Windows\System32\cmd.exe /C start /affinity 5 fallout3.exe
Now save it, maybe change the icon to the FO3 one.
What this does is limits the game to two physical cores. If you have hyperthreading, it will only use the actual physically seperate cores. You will still need to open up the fallout.ini file in your documents\games\fallout 3 folder and add iNumHWThreads=2 to the general section. Do not bother with any other ini 'tweaks' they only serve to hurt performance. For example, threadedai is set to 0 by default for a reason. Don't set it to 1, if it even does anything at all. And don't mess with the background load settings unless you want the game to stutter more when loading the world.
So there, not only have you tricked the game into thinking you only have 2 cores (which is perfectly fine performance-wise) but only two real cores will be assigned to the game so nothing Windows does in the background will cause it to crash. Is this a for sure fix? I dunno, hasn't crashed yet but that doesn't mean anything. This works for New Vegas if you want to try it there too but steam has to be closed before running the shortcut (otherwise it will load with the affinity set on all cores)
So why is everybody with Windows 7 reporting freezing? Because if you buy a new computer it comes with Windows 7, therefore everybody thinks it's a Windows 7 issue. If you go to google and search for "quad core fallout 3 freeze" you'll find tons of archived posts describing the very same thing in Vista and XP dating back to the game's release in 2008 so it is hardly new. We are unfortunately seeing it now that core i CPUs with 4 threads at the least are in the mainstream
Just an update, New Vegas must utilize multi core better. Verified with FRAPS that forcing New Vegas to use 2 cores caused reduced framerates and also bizarre framerate flucuation even when nothing goes on. Doesn't happen with FO3 though, just saying not to use this on NV. Maybe somebody will find a way (doubtful) to run FO3 using the NV executable. ha!