Twenty years after the last film in the series, Vietnam veteran John J. Rambo (Sylvester Stallone) has retreated to northern Thailand where he's running a longboat on the Salween River. On the nearby Thai-Burma (Myanmar) border, the world's longest-running civil war, the Burmese-Karen conflict, rages into its 60th year. Rambo, who lives a solitary life, has long given up fighting, choosing to remain neutral in the war-torn region. That all changes when a group of human rights missionaries seek out the "American river guide". Sarah (Julie Benz) and Michael Bennett (Paul Schulze) explain to Rambo that the Burmese military has laid landmines along the road, making it too dangerous for overland travel. They ask Rambo to guide them up the Salween River so they can deliver medical supplies and food to the Karen tribe. After initially refusing their request, Rambo eventually relents and helps them reach their destination. Less than two weeks later, pastor Arthur Marsh (Ken Howard) finds Rambo and tells him the aid workers did not return and the embassies have not helped locate them. He tells Rambo he's mortgaged his home and raised money from his congregation to hire mercenaries to get the missionaries, who are being held captive by the Burmese army. Although the United States military trained him to be a lethal super soldier in Vietnam, decades later Rambo's reluctance for violence and conflict are palpable, his scars faded, yet visible. However, the lone wolf knows what he must do...

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