I can set any usable screen settings in Fallout 4 on my Windows 10.

Windowed mode can be stuck

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and it can be unable to turn it off.

Next run it can be available, but resolution drop down can be empty

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It is impossible to run Fallout in any combination. It can either run highly distorted and corrupted (see menu background):

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or it can run partially occupying the desktop

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Is it possible to get something consistent?

up vote 5 down vote accepted

The issue is that you're using a 21:9 monitor, and Fallout 4 doesn't support that. You'll need to use the mod TruBy9 Ultrawide to allow it to work with this monitor aspect ratio, and manually set the isize W and isize H in (default location)Documents/My Games/Fallout 4/falloutprefs.ini to 3440x1440. Then keep in mind that any time you change your graphics settings you'll need to go back in and change the resolution in the ini.

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