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So I can't even make it to the main menu for Fallout 1 right now on Windows 7 64 bit. I can see and skip the first video just fine, but if I push any buttons at all on the part starting with "Brian Fargo" it freezes and the background turns neon green. Hitting escape exits back to desktop. I tried with and without all the latest official and unofficial patches I saw here. If I leave the intro video running it will eventually just end into a really distorted screen and stay there until I exit it.

I tried using the high-res mod and that gave me a different issue. I set it up following the instructions and when the game booted up it was a black screen, I could hear the video intro playing but could see nothing. Hitting escape again exited to desktop. I tried messing with the resolution and colors in the config file with no luck.

I found a ddlhack online that seemed to work, however I couldn't turn on hi-res textures or adjust the color scheme without the game glitching out severely. When I turned off the hi-res patch the game started fine but ran extremely slowly, so slowly it wouldn't be worth trying to play.

Any help would be appreciated, I'm really at a loss.
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Dang, I'm having this exact same problem.
I had the same problem, tried the same and finally installed the latest graphic card drivers. Now everything works completely fine.