Rambo: Last Blood is a 2019 American vigilante action film starring Sylvester Stallone as Vietnam War veteran John Rambo. Directed by Adrian Grünberg, the film serves as a sequel to Rambo (2008), and the fifth installment in the Rambo film series. The story sees Rambo traveling to Mexico to save his adopted niece, who has been kidnapped by a Mexican cartel and forced into prostitution. Paz Vega, Sergio Peris-Mencheta, Adriana Barraza, Yvette Monreal, Genie Kim aka Yenah Han, Joaquín Cosío, and Óscar Jaenada star in supporting roles.

Plans for a fifth film were announced on and off again since 2008, with different iterations developed and canceled. The film was finally announced in May 2018, with Grünberg attached to direct. Principal photography began in October 2018 in Bulgaria and Spain and ended in December 2018, with additional photography in May 2019. Brian Tyler returned to score the film.

Rambo: Last Blood was theatrically released on September 20, 2019, to negative reviews from critics with praise for action sequences and Stallone's performance, but criticised its script, graphic violence and accusations of racist and xenophobic attitudes towards Mexico. The film grossed $91.5 million worldwide against a production budget of $50 million and print and advertisement costs of $30 million.

Eleven years after the events in Burma, John Rambo lives in Bowie, Arizona, at his deceased father's horse ranch, which he manages with his old friend Maria Beltran and her granddaughter Gabriela. Gabriela gets informed from her friend Gizelle that she has found Gabriela's deadbeat father Manuel in Mexico. Despite their protests, Gabriela secretly travels to Mexico, where Gizelle leads her to Manuel's apartment. When Gabriela asks him why he abandoned her mother, he cruelly reveals that he never loved her and never wanted a child, breaking Gabriela's heart.

Gizelle takes Gabriela to a nearby club, where she is drugged and kidnapped by the enforcers of a Mexican cartel. After learning of Gabriela's disappearance, Rambo rushes to Mexico and interrogates Manuel and Gizelle about Gabriela's whereabouts. Gizelle reluctantly leads Rambo to the club where Gabriela was last seen and Rambo confronts El Flaco, the man who last spoke with Gabriela. A mysterious woman named Carmen Delgado follows Rambo as El Flaco leads him to Gabriela's supposed location. Rambo is confronted, beaten and marked by the cartel, led by brothers Hugo and Victor Martinez. They take his driver's license, revealing the location of the ranch and a photo of Gabriela, whom Victor recognizes. The cartel vows to mistreat Gabriela further due to Rambo's actions.

Carmen takes Rambo back to her home, where she cares for him until he fully recovers. Meanwhile, Gabriela is repeatedly dosed with heroin and sold into sexual slavery. Carmen says she is an independent journalist investigating the Martinez brothers, who were responsible for the death of Carmen's sister. Rambo later raids one of the brothels, killing several men until he finds a drugged Gabriela. While driving home, Rambo thanks Gabriela for giving him hope and meaning for the last ten years, but she dies from an overdose. An enraged Rambo sends Maria away, rigs the ranch with booby traps for a confrontation, and later returns to Mexico to ask for Carmen's help in finding Victor. Carmen initially refuses, telling Rambo it will solve nothing, but is convinced after he appeals to her grief and frustrations.

Rambo raids Victor's home, kills the guards and decapitates Victor. Hugo leads a group of hitmen to Rambo's ranch, where the hitmen are killed through booby traps. Saving Hugo for last, Rambo uses his bowie knife, cuts his chest open and rips out his heart. In the aftermath, a weakened Rambo sits on the porch of his father's house, vowing to continue fighting and keep the memories of his loved ones alive. During the end credits, the flashbacks of Rambo's battles are shown, with Rambo saddling up his horse and riding off into the sunset.

Louis Mandylor and Aaron Cohen portrayed the Sheriff and State Police Captain in the opening scene of the extended cut, respectively.