In Thailand, John Rambo is living peacefully capturing snakes and transporting people and cargo in an old boat. When a group of Christian missionaries asks to be transported to the war zone in Burma to help the locals, the reluctant Rambo only accepts when Sarah Miller presents her point of view about their humanitarian mission. Rambo leaves the group in the requested location, but the village where they are working is attacked by the sadistic army of Major Pa Tee Tint, the locals are slaughtered and the missionaries are abducted. Later a member of their church meets Rambo and asks him to transport a group of mercenaries hired to rescue the missionaries.

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Sylvester Stallone, Julie Benz, Matthew Marsden, Graham McTavish, Reynaldo Gallegos, Jake La Botz, Tim Kang, Maung Maung Khin, Paul Schulze, Cameron Pearson, Thomas Peterson, Tony Skarberg, James With, Kasikorn Niyompattana, Shaliew 'Lek' Bamrungbun.