Frostyfirefly: I'm running it on Windows 10, the game is performing pretty choppy for me; the music is constantly stuttering and the gameplay has a jerkiness to it. I went to options and raised the number of samples to 16, and experimented with the level of detail, and it seems that high detail with a high number of samples actually makes the game go a bit faster. I also went to compatibility mode, and ran it as Windows 7, which seems to slightly improve the performance, but it's still pretty choppy / stuttery. Does anyone have a solution for this?

Megacyclo: Did you try increasing the cycles in DOSBox?
A similar probleml happens with Op. Body Count where the default "DOSBox settings are insufficient and the game is a slideshow.
Using/Holding CTRL-F12 until the game is smooth enough might do the trick?

Never experienced that with Last Rites on Win10 myself though.