This is a conservative list of mods for Fallout: New Vegas which I feel improve what's already there rather than changing it (much).
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Install xNVSE.
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Install FNV 4GB Patcher. I used to use FNV4GB but it prevented me from using ReShade. Even if you don't use ReShade this is probably still the better option as it simply patches the New Vegas executable rather than using in-memory patching and an extra executable.
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Install New Vegas Tick Fix.
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Install New Vegas Heap Replacer. Replaces the game's heap memory management system with a faster implementation.
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Install BethINI.
- Disable mouse acceleration.
- Clamp the framerate to 60 otherwise you might get physics and lip sync bugs.
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Install LOOT and run it after you've finished installing all the mods you're going to use.
- Yukichigai's Unofficial Patch - Tons of bug fixes that aren't in the official patches.
- Unofficial Patch NVSE Plus
- JSawyer Ultimate Edition - After New Vegas was released, lead designer Josh Sawyer released this mod which fixes a bunch of oversights, rebalances things and generally improves the game. JSawyer Ultimate Edition takes the original mod and improves it further. Also the corresponding GRA Merged.
- Take All Button R
- Simple DLC Delay - Integrates the DLC in a much more immersion-friendly manner.
- CONELRAD 640-1240 - Adds an extra radio station consisting of music and radio spots that fit the atmosphere of the game perfectly.
- Universal Item Sorter
- Improved LOD Noise Texture
- Uncut Wasteland - Adds back in scenery, "clutter" and NPCs that were cut from the game, supposedly to accommodate the resource-constrained console versions of the game.
- Inventory Saviour - Weightless Junk I didn't bother much with crafting before installing this mod as keeping track of the various recipe ingredients was a ballache.