If using dual monitors, disable your second one from your Windows display settings.Launch the game in Windowed Mode by selecting Options from the Fallout 3 Launcher and ticking the Windowed box under Mode.Issues associated with launching and playing the game can often be resolved by changing the following display options:
If you continue to experience issues, you can also try the following troubleshooting steps: Note: Fallout 3 is not optimized for Windows 7 and later operating systems. To resolve Fallout 3 performance issues on Windows 7 or 8, you should first ensure that you meet the game's minimum requirements and you have the latest NVIDIA or AMD graphics card drivers installed.