I just recently did another playthrough of new vegas heavily modded. My main intention was just to get the game looking better and playing smoother and keeping it vanilla.

Recommended Mods:

• Mod Looting - Allows you to pickup weapon mods off corpses. I used "A bit common".
• Continue After Ending - Allows you to continue after finishing the game. I don't play through the DLC during the game. I wait till im level 30 and done with the game.
• 4GB New Vegas
• NVSE
• Ambient Wasteland 2 - Enhanced ambient audio
• ConelRad - Adds another radio station to the pipboy dedicated to civil protection.
• New Vegas Bounties
• Book of Water - Enhances armor textures
• Enhanced Blood Textures
• Essential Visual Enhancements - Enhances weapon visuals
• NMC Large Texture Pack
• Wasteland Clothing Hires HD - Enhances civilian clothing
• Wasteland Flora Overhaul - Overhauls flora
• New Vegas Extended Map Markers - Adds a bunch more map markers
• New Vegas Stutter Remover - removes the micro stutter from the game
• Ownerless Trash - You can search trash without being called a thief
• The Someguy Series - This is the main file for New Vegas Bounties
• CASM Chem, Alcohol, and Med extender - Adds more chems, drinks and meds but extremely buggy.
• CASM - Removes default saving system in game. Autosaving in New Vegas is buggy with lots of mods.
• Increased weapon jamming
• Interior Lighting Overhual
• Manual Reload - Game no longer reloads weapons for you.
• Mission Mojave - Fixes bugs in game
• Nevada Skies Weather Effects - Adds weather systems to the game
• New Vegas Enhanced Camera
• Old World Blues Nerfed - Nerfs the bullet sponge enemies
• Pipboy Smooth Light - Fixes pipboy lighting
• Underwater FX - Enhances underwater effects.
• Mission Mojave MMUE - More bug fixes
• New Vegas Anti Crash
• FP Gun Follows Crosshairs
• Ironsights Camera Recoil Removal