Rambo is approached by a group of Christian aid workers from the United States who want to pay him to take them on his boat fromThailand - up river to the war torn Burma to help the sick and injurred. After some convincing he takes them there. Shortly after, he finds out they were taken hostage and he goes with a group of mercenaries that were hired by the church to rescue them. They locate the camp where the missionaries are being held, and at night they rescue them. The soldiers find that several of their men have been killed and they give chase. Some of the missionaries and some of the mercenaries are killed, but Rambo saves Sarah (Julie Benz) and her husband. There is a big bloody shootout at the end between Rambo and the soldiers. Rambo, with the aid of rebels that arrive later eventually kill most of the soldiers and the ones that are alive retreat.