Fallout 2 is notable for being the first video game to feature same-sex marriage through opportunities to marry Miria or Davin, a sister and brother working at the slaughterhouse in Modoc, in a shotgun wedding regardless of the Chosen One's gender or party limit. This marriage is permanent unless Miria/Davin dies in some way, is sold to slavery, or is divorced at New Reno's Drunk Cupid Chapel in exchange for a bottle of alcohol.

According to game designer Chris Avellone in 2019, nobody at Black Isle Studios working on the game was against the inclusion of same-sex marriage, and noted that "fans didn't seem to care" about it when playing the game. He believed the reason for this reception was because of it only being offered in Modoc, a tight-knit small town "where things can get wild and weird" that was more receptive to it than a more "modern" location like Vault City.