this is tested on nVidia GeForce GTX 960M with GameReady drivers, and Intel Integrated Graphics "HD Graphics 530" with windows updates drivers, and on AMD Radeon HD 7970.
TODO: test on Win 8 / 8.1 / 10
1: make sure you have Windows 7 Service Pack 1, at minimum. should have all recommended+ windows 7 updates.
2: download and install the "DirectX End-User Runtime Web Installer" from https://www.microsoft.com/en-us/download/details.aspx?displaylang=en&id=35 (even though you already a recent directx installed from windows updates, this installer will install legacy drivers/dlls all the way back from 2005 at least.)
3: download and install Zeus nGlide wrapper from here - http://www.zeus-software.com/downloads/nglide (this is a "glide wrapper", translating legacy Glide API calls that Mfatigue can, and prefer to, use, to modern DirectX calls.)
4: reboot your computer BEFORE YOU INSTALL, then install Metal Fatigue normally to C:\metal when it asks you what kind of graphic api to use, chose the 1 with "GLIDE" in the name (that will make it use the Zeus nGlide wrapper)
5: right-click on the "Metal Fatigue" icon on your desktop, and press "Properties", and go to the "Compatibility mode" tab, and enable the following settings: "Run this program in compatibility mode: Windows XP SP2" (NOT win 2000/98, which it actually was designed for, oddly enough this makes it extremely laggy), "Disable Visual Themes", "Disable Desktop Composition", "Disable Display Scaling on high DPI settings" (it will still scale, it just does it manually, which is stable), "Run this program as an administrator". then press the "Apply" button, then press "OK"
6: now press the start button, and write "notepad.exe", a program will appear quickly, open it. in notepad, write the following:
taskkill /IM MFatigue.exe /F
taskkill /IM explorer.exe /F
echo when you want to stop playing and return to windows, press enter here.
taskkill /IM mfatigue.exe /F
then press Ctrl+S , change the "Save As Type:" to "All Files (*.*)", then save as C:\metal\killstart.bat , press Save, then press the X
7: back to the shortcut on the desktop called "Metal Fatigue", right click on it, press "Properties", then change target to: C:\metal\killstart.bat
then press "Apply", then press "OK".
congratulations! you're now ready to play, just double click on the shortcut called "Metal Fatigue". however, you should turn off all background programs before playing, as they may make the game unstable. notably, Steam, Skype, Discord, and Chrome with facebook-notifications, may make the game crash if they make a "you got a message" notification window in the background.