NOTE: This spoiler was submitted by Jeremy

The film opens in Arizona where John Rambo (Sylvester Stallone) now lives on his father’s ranch, which he shares with his close friend Maria Beltran (Adriana Barraza) and her granddaughter Gabrielle (Yvette Monreal), the latter who views Rambo as something of an uncle. In the years since his last battle, Rambo has been plagued with PTSD and is still haunted by the memories of death and bloodshed. He has also been constructing a series of tunnels beneath the ranch.

Gabrielle asks if she can invite friends over to the tunnels for a party, which Rambo allows. During the party, Gabrielle is contacted by her friend Jezel (Fenessa Pineda), who has information on Gabrielle’s long lost father Miguel (Marco de la O). She explains her situation to Rambo, who knows the man and tells Gabrielle that she should not have to go looking for a man that never bothered to have any part in her life. He also adds that he knows how terrible men can be, and pursuing this man would only hurt her. This carries into the next morning when Gabrielle argues with Maria about going to Mexico to find Miguel, who apparently used to beat Gabrielle’s mother before Rambo intervened.

Gabrielle pretends to be heading out somewhere nearby, but she instead drives to Mexico to meet with Jezel. She leads Gabrielle to Miguel’s house. He privately speaks to her and firmly tells her that he never wanted anything to do with her or her mother. Gabrielle leaves in tears, but Jezel tries to cheer her up by taking her out to a club. There, Gabrielle talks to a man and has drinks before he slips drugs into her drink.

The next day, Maria gets a call from Jezel saying Gabrielle has disappeared. Rambo takes it upon himself to drive out to Mexico and find Gabrielle himself. He stops at Miguel’s house and intimidates him by saying he should have broken his neck all those years earlier, and that this whole mess is his own fault. Rambo then locates Jezel and quickly figures that she sold Gabrielle into trafficking after he notices that Jezel is wearing Gabrielle’s bracelet that belonged to her mother.

We then see that Gabrielle is lined up among other kidnapped young women being held captive by a cartel. One of the leaders, Victor Martinez (Oscar Jaenada), drags one woman who tried to escape inside and threatens them all with death if they try to escape again.

Rambo forces Jezel to take him to the club where she took Gabrielle. There, they spot the man that Gabrielle was talking to. Rambo is observed by a nearby woman named Carmen Delgado (Paz Vega). Rambo follows the man to his car and threatens him with his knife. When he refuses to talk, Rambo hits him hard in the shoulder with the butt end of the blade before stabbing him in the leg and then digging into the shoulder wound to crack his bones painfully before the man reveals where Gabrielle was taken. Rambo drives to the location of the cartel’s base where he is easily spotted. Carmen has also followed him. Victor his joined by his brother Hugo (Sergio Peris-Mencheta) and their gang of men. Rambo walks to meet with the brothers with the men surrounding him. He takes out a picture of Gabrielle, and the brothers recognize her. The gang beats Rambo badly, and Hugo threatens Rambo with hurting Gabrielle since he came out for her. Victor then marks Rambo by cutting a V on his cheek and leaving him there for dead. He is rescued by Carmen, but the brothers proceed to torture Gabrielle.

Over the next few days, Rambo recovers in Carmen’s house while Gabrielle is forced into trafficking while also being drugged continuously. Meanwhile, Maria can only sit around and wait for Rambo and Gabrielle to return. After Rambo wakes up, Carmen tells him that her sister was kidnapped by the Martinez brothers’ cartel and she was killed. She has been investigating them ever since in the hopes of bringing them down. Rambo gets himself ready to get Gabrielle back.

Rambo infiltrates a brothel and slaughters the men running the place, as well as several unlucky clients. He orders the women to run, but they all say that they will be killed if they run. He manages to find Gabrielle’s room, where she is barely conscious. Rambo gets her out of there. The Martinez brothers later come across the place and know that Rambo is responsible for the deaths of all their men. Victor chastises Hugo for not killing Rambo when they had the chance. On the drive back to Arizona, Rambo tries telling Gabrielle that she has been a source of hope for him in the years since he came back home, and that he cares about her a lot. Sadly, Gabrielle dies moments later after succumbing to the excess drugs. Rambo returns home in the morning and must break the news to Maria.

Rambo and Maria bury Gabrielle in the backyard. Maria leaves the house to go stay with her sister, and she tells Rambo that she will remain sad until the day she dies. Rambo, now fueled by hatred and revenge, begins to rig the tunnels and set traps across the ranch. He returns to Mexico to ask for Carmen’s help in finding Victor. She is hesitant at first since she doesn’t think that any good will come of it, but Rambo convinces her since these men are responsible for the deaths of people they both loved.

Rambo locates Victor’s home and proceeds to slay every man in his path before getting to Victor. When Hugo arrives, he finds Victor’s headless and bloodied corpse on the bed with Gabrielle picture stabbed into his chest. Rambo is then seen driving back, and he tosses Victor’s head on the highway. Hugo and his men prepare for war.

The cartel drives to Rambo’s ranch where he waits for them. The first vans that drive onto the property get blown up by one of the booby traps. The rest of the men begin to storm the tunnels, where they get impaled by other traps or get blown up by C4 explosives. Rambo lurks in the darkness and blasts any man that he finds, as well as dismembers them with his blade. As Hugo loses more and more men, Rambo gets closer to him and sends out a message through the radio to let Hugo know that his death is coming. Rambo blows up the tunnels to bury all the remaining men underground, but Hugo manages to get out and make it into the barn. Unfortunately for him, Rambo is waiting, and he fires four arrows at Hugo to pin him against the wall. Rambo approaches him and tells him that because Hugo ripped out Rambo’s heart in the figurative sense, Rambo will now do that to him literally. He deeply cuts into Hugo’s chest with his blade before pulling his heart out and showing it to him before Hugo dies.

Rambo, wounded from the fight, goes to sit in his rocking chair. His voiceover states that he is now alone, as everyone he has ever loved is now gone, but he will continue to fight to keep their memories alive. After a while, Rambo picks himself up and rides his horse into the sunset.

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John Rambo has been living peacefully on his father's ranch in Arizona with his friend Maria and her granddaughter Gabrielle. When Gabrielle learns that her father Miguel has been found in Mexico, she travels there against Rambo and Maria's wishes to meet with her friend Jezel and find Miguel. When she does find him, Miguel tells her flat out that he never wanted to be her father. Jezel takes Gabrielle to a club to cheer her up, but she is kidnapped by a Mexican cartel led by brothers Hugo and Victor Martinez.

Rambo finds out and goes to Mexico to save Gabrielle, but the cartel beats him, and the brothers torture Gabrielle after learning of her connection to Rambo. A woman named Carmen Delgado, whose own sister ended up dead because of the Martinez brothers, helps Rambo recover. He goes to a brothel to recover Gabrielle, but she dies on the way home due to being forcibly drugged over a few days. Rambo and Maria must bury her, and Maria goes to stay with her sister.

Rambo returns to Mexico for revenge and is helped by Carmen to find Victor. Rambo slaughters Victor and his guards to lure Hugo back to the ranch, which he has rigged with traps and explosives. Sure enough, Hugo and his men storm the ranch, where they are blown up, blasted, or eviscerated. Rambo saves Hugo for last and brutally kills him by cutting his chest open and ripping his heart out.

Although weakened in the final battle, Rambo vows to continue fighting for the memories of his loved ones.