I just started playing this game for the first time. Pretty damn good.
I set off in a random direction as soon as the game let me (which, mercifully, was pretty quickly). The first place I encountered was a little abandoned campsite with little flies buzzing around. I was like: Oh, cool, these must be like the bloat flies in FO3. WRONG. Little fucking flies fucked me up.
Soooo, I reloaded and set off in a different direction. I came across the Goodsprings cemetary, and then Goodsprings. Met some nice folks, committed to some missions, and then promptly ignored said missions in favor of more exploring.
The first really jaw dropping moment I had was encountering the Mojave Outpost. The giant statues (not sure if spoilers are necessary now, but doing so just in case), while somewhat cheesey, also made an imposing impression on me as I approached.
The second "wow" moment I had was infiltrating a Legion camp, wiping everybody out, and freeing an enslaved family. Fuck you, you oppressive tyrant fucks. Eat plasma rifle.
Edit: Oh yeah, and my biggest complaint thus far was also my biggest complaint with FO3. The main urban area is a pain in the ass to navigate. It's like legitimately unfun. I avoid it. It's really unfortunate that they can't get it right.