The Sega Master System version, released in 1988, is a light gun rail shooter in the lines of Operation Wolf. The Light Phaser is supported. What makes this game also unique is that unlike the NES (and Sega Master System Port, ironically) port of Operation Wolf, as long as the player has ammunition in the game, the light phaser's trigger can be held down to supply full automatic shooting. When the ammunition runs out though, the player will have to pull the trigger each time when shooting.

The Sega Mega Drive version, released in 1989, follows Rambo in six missions, in each one with various objectives. Besides finding the exit of the level, in some missions, prisoners must be freed or enemy ammunition supplies destroyed. Rambo is controlled from an overhead perspective and has several weapons at his disposal. Besides a machine gun that never runs out of ammo, he can use a knife for close range kills, set off timed bombs and use his famous longbow with explosive arrows. Ammunition for the bow and the bombs is limited and can be collected from dead enemies. Rambo himself, on the other hand, is vulnerable and can be killed after one hit.

After some of the missions, the perspective switches to a view behind Rambo and additional boss fights take place. Soviet tanks or helicopters must be destroyed using the crossbow. While aiming the bow, Rambo cannot move, but otherwise he can hide behind rocks or other obstacles from enemy fire. This is reminiscent of the Taito arcade game of the same name, which also had the player firing into the screen at helicopters and jeeps, but instead of just a single segment after each stage, the whole game is played out in this perspective.

Taito released a rail shooter based on the film as well. It features both Rambo and Sam Trautman as playable characters.

All of these versions (ZX Spectrum, Atari ST, Commodore Amiga, Commodore 64, Amstrad CPC) had three missions, and varied from the console version drastically, in terms of gameplay, graphics and music.

The first one had an overhead view, using single-screen areas, and played much like the original Metal Gear games, where catching the view of a guard or tripping an infra-red laser would trigger an alarm, where soldiers would rush in while firing. Various items and weapons, including a mine detector, glow tube, Explosive Arrows, and a Machine Gun are hidden throughout the base complex, which has both guards, and deadly traps such as land mines and electrified doors. The objective is to rescue Colonel Trautman, and escaping the stronghold.

The second has the same view, but here the soldiers are on perpetual alert, so this stage is more action-oriented. The objective is to plant eight bombs at designated areas in a large vehicle storage area (with plenty of parked tanks, transports, off-road vehicles, and a few helicopters), and then escape to the helicopter to leave the area.

The third mission is in first-person view, and the player is in a tank that is automatically moving towards the border out of Afghanistan Soldiers and tanks are the main threat, but there is also a Soviet helicopter, who serves as the boss of the level (and indeed, the game). The player can and must intercept missiles, grenades, and shells by shooting them, to minimize damage.