Hmm probably the video card chipset, or the version of DirectX you have.

More info here: http://planet-vampire.com/modules/redemption/troubleshooting.php

Some other people were playing around with Windows 64-bit. I'm not sure if this is of any help to your particular item.

http://www.gamefaqs.com/boards/914408-vampire-the-masquerade-redemption/47989763
https://activision.custhelp.com/cgi-bin/activision.cfg/php/enduser/std_adp.php?p_admin=1&p_faqid=6158

Also too, right mouse click on the game icon, and go to properties. Under the Compatibility tab try running it as a Windows 98/ME/XP compatible application.

"Also as far as i know there is now 64bit version of this game, however gog.com has modded it to run on XP or Vista 32 or 64bit. runs just fine on my windows 7 64bit. http://www.gamefaqs.com/pc/914408-vampire-the-masquerade-redemption/answers?qid=210440"

Sorry for the necro-post, but this came high in a google search, so figured it was worth responding to.

I had this exact behaviour on an nVidia 8800GT and was able to resolve it by going to the nVidia Control Panel, Manage 3D Settings, selecting the game, then changing "Antialiasing - Gamma Correction" to Off. After that, while there were one or two periods of unexplainable lag, I got 60fps very reliably otherwise.

This does not solve it for me. Other ideas? It's royally irritating.