I was planning to give this to my 11 year old nephew for his birthday but it says 16+ on the box...does this really reflect the content of this game?  I have played DS3 and I didn't see anything that would suggest the age rating should be so high!

I don't have the box, but the pc version was ESRB rated at "Teen", which is 13+.

 

Description goes: "May contain violence, suggestive themes, crude humor, minimal blood, simulated gambling and/or infrequent use of strong language."

 

....so as always with such ratings, depends on the individual child and the parents views on such things. I don't remember anything very untoward either, outside of the usual combat violence, occasional mild/subtle humor jab perhaps, as well as brief social issue themes like work-contract vs. slavery. It's been a while since I played tho.

Some of the main characters have skimpy outfits in case you're worried about sexual content and there's a bit of innuendo, nothing big but as a parent you probably want to be aware of that stuff. The game isn't super-violent though there are still a few references to killing here and there and I think there might be some blood spraying for criticals? It's no God of War, but I'm not the parent so it's not for me to decide whether that's appropriate or not.

Some of the main characters have skimpy outfits in case you're worried about sexual content and there's a bit of innuendo, nothing big but as a parent you probably want to be aware of that stuff. The game isn't super-violent though there are still a few references to killing here and there and I think there might be some blood spraying for criticals? It's no God of War, but I'm not the parent so it's not for me to decide whether that's appropriate or not.

 

On the whole there's more than a few, and some pretty violent stuff (tactic at end of the mines for example). Though, to actually realize that you have to think a bit further than normal, so it should be ok.