ESRB says Modern Warfare 2 is pretty violent

This is a first-person shooter in which players assume the roles of members of an elite squadron on the trail of a Russian ultranationalist. Players defend the U.S. from Russian armed forces, engage in skirmishes and combat missions, and track the ultranationalist in an attempt to discover his true motivations and co-conspirators. Players use machine guns, sniper rifles, grenades, and missiles to kill enemy soldiers throughout the battlefields. Realistic gunfire, explosions, and cries of pain are heard during the frequent and fast-paced combat.

The most intense depiction of violence occurs during a "No Russian" mission where players take on the role of an undercover Ranger: Several civilians are gunned down at an airport as players are given a choice to participate in the killings (e.g., players can shoot a wounded civilian that is crawling on the ground), or walk by and observe without opening fire. In either case, civilians scream and emit pools of blood as they are shot to death.

Within the multiplayer portion of the game, players can unlock "emblems" to be used on their player name cards. Some of these emblems contain images that reference drugs (e.g., a cannabis leaf; a name card with a depiction of a joint). Dialogue in the game contains profanity in both English (e.g., "sh*t") and Russian (e.g., "f**k" and "motherf**ker").