The List:
Oh shit where to begin.......I know many things have already been said but I'll just put down my ideas for completion.
*Give ammo & everything, weapons,meds (bottlecaps too) weight (RL weight approximations)
*Perks...less perks which boost skills & SPECIAL and more which imbue some special ability not achievable otherwise.
*Redo SPECIAL for example strength requirements for heavy weapons (and or power armor requirements to wield them).
* Make it so you can no longer fix "crippled" limbs UNLESS you have a very high medicine skill. If not you will have to see a real doctor to fix it.
*Make radscorpions poison you and if you don't have antidote you will be succumb to the poison. Also redo the scorpions texture to this
http://www.centralpets.com/critter_images/insects/scorpions/SCP_0006200_20030415214842.jpg color scheme which is a NEVADA scorpion. Consistency makes all the difference.
*Get rid of weapon degradation affecting how much DAMAGE a gun does. This is ridiculous. The only things weap condition should affect are accuracy & reliability (jamming) Weapons can still degrade but just far slower.
*Make power armors much more protective and possibly immune to small arms pistol rounds. Also you should be immune to scorpion poison while wearing power armor. Also no more knifing someone in power armor. Also NO SNEAKING in power armor.
*no more pip boy pausing realtime. You'll need to make sure your surrounding are safe before using it.
*insta stimpack health replenishment need to not be so instant.
*Backpacks or some sort of mechanism to visually depict how you are carrying your items. Also if you have followers they have backpacks as well to hold your excess stuff.
*VATS needs to be changed so you take the same amount of damage as in realtime. Thus no longer making it the cheat mode it currently is.
* weapons need to be appropriately deadly/accurate for their type & condition. A missile is a missile. It will f..k you up and should. Miniguns should be something you don't want to have pointed at you. All the more incentive not to get hit by one or take out that guy pointing it at you ready to fire ASAP. Combat needs to be way more tactical and hinge on deciding who & what to take out first to maximize you chances of survival. De incentive-ize this 'run at each other till one of you drops' idiotic, simplistic, boring gameplay.
*fix the invisible barriers which block your shots when you are visually cleared of the object.
* Enemies in general need to be ungimped by not having shitty broken weapons & armor + pathetic gimped health on top of that. Let's make things challenging so you feel like you actually accomplished something hard fought instead of just pwning the world.
*feral ghouls don't need bottlecaps as loot.....
*Make enemies able to be wounded and lying on the ground yet not dead. They could bleed out or you could go up and try to extract some info out of them before they die. Or you could give them a stimpack to save them in return for info.
*Fast travel....I don't like it. A better alternative is needed.
*Make areas look distinctive and not so "samey" I get immensely tired of seeing the same damn buildings/models/textures everywhere. Unique locations are a must.
*Ability to give NPCs weapons or armor without having to pickpocket them
*Karma is bullshit. Reputation should be on an individual NPC basis depending on what they know/heard/seen of you.
*Duststorms......It's the desert let's make it awesome.
* New enemies which are native to the region. I can't think of any specifics right now but I'll add some as I figure out some good candidates. For example on what NOT to include are mirelurks....crabs + desert = really stupid.
* If there are super mutants do something new with them like make them a different color (maybe more reddish to simulate more sun exposure).
*Quests/story/plot etc....yes please make all of these things make some sense, be compelling and not insulting to gamers intelligence. "fetch" quests are REALLY REALLY boring unless there is something extraordinarily important to fetch. Violins and Cola are not something any sane person should give a f..k about in the post apocalypse. Fetch quests if done need to be integral to the greater story not trivial BS errands. Also don't make people choose between 2 equally shitty choices in quest outcomes. One way to avoid this is make the "good" choice FAR FAR more demanding and time consuming to accomplish when compared to the "bad" choice. However ideally more than 2 outcomes would be desired (see the "oasis" quest for a good example of a quest done right). No ridiculous artificial conundrums just choices that aren't deliberately stupid and unnecessarily conflicted to create fake 'conflict' where none should exist.
In summary make them smart.
*fix how you can see something yet you cannot shoot it...this is really irritating as you have to get close before you can engage enemies. Also enemies should have the equal ability to spot you from way out and start taking shots at you as well.
*Item descriptions in pip boy...a no brainer. Please
*No more numerical "ammo" count for energy weapon ammo. Just have the "pack" and its "charge" level.
*Open up buildings so you (and enemies) can fire from high story buildings and have epic warfare/assaults rather than the typical everybody is hanging out at ground level and the boring gameplay that brings. Think WW2 where a sniper is pinning you down from a 5th story window or something. MORE TACTICAL. less mindless street clusterf..king. Make enemies take maximum advantage of their surroundings which will make things more challenging for the player.
*Make it so you must eat something (anything) to stay alive. It doesn't have to be alot or often but you should have to eat something once in a while to sustain yourself. It would really add to the tactical nature. If you fail to eat then you could slowly get weaker and weaker until you find some food/water.
Ok that's all for now. I know there is tons more but I can't think of it all right now. I'll add to it later maybe.