With the realistic bent comes realistic visuals. Characters are detailed, but at the cost of the environments. The sense of scale is really impressive, though there isn't much to see in the environments. There's a noticeable lack of detail, which is only magnified considering the amount of time spent driving around the area. For all I know, Red River might present an accurate look at Tajikistan's landscape, but even if that is the case, some artistic license is acceptable.
Voice acting is, for the most part, good. Your Sergeant spends much of the campaign rambling on about everything and finding new ways to use certain sentence modifiers. Some harsh language is expected, but there's a line. I enjoyed some of the squad chatter, but it tends to drone on, eventually becoming background noise.
Weapons fire and other ambient effects are incredibly solid and almost make up for the game's other audio shortcomings.