Yes, you can customize gender, facial features, facial hair (my guy had mutton chops), you can be good, bad, choose to follow your dad in the main quest or avoid it completely, you can be an assassin, a bounty hunter, can choose from a wide variety of weapons, armor...
Alright, theres just too many features to mention. Oh yeah, the VATS system is extremely kickpie, I only wish I discovered it BEFORE I completed the main quest.