- The sheer scope of the mass grave you find in the early game. Made worse when you hear on the radio that survivors in Vyshny Voloychok sent an expedition to Moscow, who haven't returned. The implications are clear. Made worse when a radio personality from said city drives home how utterly crappy Moscow is even from an outside perspective.
- One of the most notable is during the Volga level, where you can, if you've done the right sidequests, enter a room filled with coffins, where the local fanatics have been laid to rest. Some of those coffins are very small...
- You can find a ledger in the room listing all the causes of death and their age, the majority is written as lack of faith (an anomaly or the Water Tsar killed them) with the second biggest cause being sickness as they have no proper doctor. And Silantius refused to let Katya treat them.
- Hearing Kirill try and contact his dad on the radio (listenable during the train level before Novosibrisk). It starts with what sounds like a more professional check in, with Kirill using codenames, stating that his father has missed 12 communication windows. Then Kirill calls him by rank, asking for a response and his voice starting to crack. Last he is full on sobbing, begging for his dad to respond and come back to him. When you meet him later, he states his dad had been out of contact for a month. You start to realize that Kirill knew full well that his father had most likely been eaten by mutants, but kept up the act of soldiering, radio contact, pretending that his father was just still on his mission, all as a coping mechanism.
- Both the endings, too. The bad for obvious reasons, the good for more subtle ones. Hearing Miller talk about his regrets and everything he forgot in his desire to keep his position is surprisingly affecting.
- The tribal slaves, they are so broken it hurts. Also worth remembering it has been only a generation top since the bombs fell and some are already indoctrinated into being slave forever. Sure the Church members, Children of Forest and Metro citizens all have their despairs and fanaticism in some way or other but the slaves gave up all their self esteem and are willing to die for their masters' amusement.
- Entering a certain house in Volga has you find a large room filled with corpses. Continuing on, you find a body hanging from a noose. The nearby journal is that of a doctor trying to treat irradiated patients, slipping into despair as they die one by one. When he woke up and discovered he was the only one left alive, there was only one thing he could do. The house is filled with ghosts when you turn to leave.
- The backstory for the Pioneers and the Pirates on the Taiga level, they were all originally students of a teacher who taught them survival skills and initially they all got along well and seemed capable, so the teacher left them to their own devices, only to be horrified when the pirates formed and became just as bad as the bandits they were fighting against, the final tape of the teacher is especially heartbreaking to listen to as he despairs at how the pirates seem to outnumber the pioneers and he commits suicide out of guilt and despair for how terrible the world has become.
- Also for the fact that the valley they all live in is doomed as the dam is about to crack, and with the water being radioactive, the dam breaking would wipe everyone in the area out. It's sad for the Order as they had high hopes of settling down there, and it's more gut-wrenching when you read the unfinished letter from one of the members of the Pioneers, despairing that their expedition to find the reservoir turned out to be all for nothing.
- The Dead City, all of it, especially when you find out that the many citizens died because the higher-ups hoarded most of the anti-radiation medicine all for themselves and had anyone that rioted in protest executed and dumped into a pit, the letters you read paint an especially heartwrenching picture, especially the one from a security guard who watched the citizens overrun a military checkpoint and saw the bombs falls.
Tear Jerker / Metro Exodus