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The film's plot is inspired by the Vietnam War POW/MIA issue. In the movie, Rambo gets released from prison in a deal with the United States government to document the possible existence of missing POWs in Vietnam, but is given strict orders not to rescue any. When Rambo defies his orders, he is abandoned and forced once again to rely on his own brutal combat skills to save the POWs.

The musical score was composed by Jerry Goldsmith, conducting the British National Philharmonic Orchestra, although Goldsmith also made heavy use of electronic synthesized elements. The main song is sung by Stallone's brother, singer-songwriter Frank Stallone.

01 Main Title 2:08
02 Preparation 1:12
03 The Jump 3:12
04 The Snake 1:43
05 Stories 3:23
06 The Cage 3:48
07 Betrayed 4:20
08 Escape From Torture 3:30
09 Ambush 2:38
10 Revenge 6:12
11 Bowed Down 1:02
12 Pilot Over 1:48
13 Home Flight 2:56
14 Day By Day 2:06
15 Peace In Our Life
Music By – Frank Stallone, Jerry Goldsmith, Peter Schless Vocals – Frank Stallone 3:12