Prior to the Brotherhood's Scourge of the Pitt, downtown, like the rest of the city, was completely lawless and inhabited by raider gangs. However, since Ashur took control of the city and assimilated or killed all of the raiders, downtown has since been turned into an oppressive slave den. The citizens of the Pitt who survived were sent to downtown where they would live as slaves. Downtown can be considered the opposite of the "higher class" Uptown.
- There are two terminals called Postal Terminal DPW to be found on the upper level, they are only accessible after completing The Hole, providing a bit of pre-War background information.
- Near Kai is a broken television that can be opened to obtain about 10 stimpaks.
- After talking to Midea, if one looks up onto the catwalks, they can see a slave being beaten by a Pitt raider.
- There is a slave held by their arms and head in a stockade near Midea's house that can be killed at the loss of no karma. If left alone, at the end of The Pitt storyline the slave will either be still alive if the player character sided with Ashur, or dead and left hanging in the stockade if the player character sided with Wernher.
- There is a red combustion engine in the alley adjacent to Midea's house where some loot can be found.
- There is a broken fire hydrant containing a stimpak on the way to the mill, near Adan.
- Walking past the first set of slaves, there is a mailbox containing a set of brass knuckles.
- It is possible to get behind the locked cage door (near Midea's quarters) by using V.A.T.S. and an auto axe to kill a raider downstairs.