First off, this isn’t for everyone, and I obviously can't guarantee that this will work for you. If you’ve tried to fix CTD’s and can’t find the solution in your mods or settings- even though the the crashes began some time into your play-through, this may be your fix.
So I’ve seen this issue first hand on 2 completely different computers. Both high spec. I’ve tried to find the cause for quite a long time and now I have. Additionally, I’ve heard others experiencing similar issue often titled ‘occasional crashes’, and I will post this solution in hope that more people will be able to save their Fallout 4 experience.
In event viewer, one may find information about the crash and the relevant module. Mine was named Msvcr110.dll, contributed by the Visual C++ installer- on two completely different computers. Yours may be the same, or a similar .dll file also contributed by Visual C++. This is worth checking in event viewer at the time of a CTD before doing any of these potential fixes unnecessarily.
Some may experience these crashes with newer versions of Visual C++ (the redistributables installed through the first time setup in many, many games found on Steam), as I found could not be fixed completely by ‘repairing’ through the Visual studios downloads and applications found in the steamappscommonsteamworks shared_commonRedistvcredist(version year) folders. My fix, and I suspect the fix for many others, will be to delete all versions of the Visual C++ through the “add or remove programs”. After this, go to steamappscommonsteamworks shared_commonRedistvcredist steamappscommonsteamworks shared_commonRedistvcredist2012 (OR the _commonRedist folder found in your Fallout 4 folder if none are present in steamworks shared) and reinstall the appropriate (x64/x86) files. The 2012 version is the only one I could get a crash free game on. I installed both x64 and x86 from the 2012 folder as is appropriate to my system.
I suspect that playing other games with newer versions of visual C++ as a requirement may disturb this fix in the future. I hope someone may be able to clarify if this is the case. It’s a fast and easy fix, and I sincerely hope this helps some experiencing occasional crashes.
Open event viewer. Observe as a CTD take place in FO4. Find the error message after a refresh in event viewer. If it is a .dll and you suspect the relevant module is contributed by Visual C++, delete all versions of Visual C++ through add or remove programs. Go to steamappscommonsteamworks shared_commonRedistvcredist steamappscommonsteamworks shared_commonRedistvcredist2012 and reinstall x64/x86 depending on your system.
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