The state of Missouri will be filled with a couple of small towns for the player to explore and interact with, but there will be one major city for the player to go to. It is located in the ruins of St. Louis and it is a small city called Arch City. In the city, the player will have the option to either help out the city expand by going out into the ruins of St. Louis outside of the city and clearing out feral ghouls that infest it, consisting of old and new types of feral ghouls, or to laid waist to it by making a huge hole on the wall allowing the ghouls to infest into the city, killing eveyone.