I don't mean within the game, there is basically a list of games that won't run for me in Windows 7 64bit (but I believe they ran before with Windows 7 64bit, the only change to the PC being my monitor to be honest).

The best comparison are these two games made by the same company, along the same format, around the same time period but one works and one doesn't. Is there anything that would prevent this?

I have tried ALL combinations of compatability mode to no avail.
It didn't work in safe mode.
It didn't work when I closed all background services/programs and ran the games.
GOG support sent me a list of things I'll put at the bottom, all of which didn't work.
Disabled AV/Firewall.
Uninstalled AV/Firewall.
It DID work when I ran them on Windows XP as a second OS and booted it in.

Any ideas?

List of things GOG support had me try
1) Please make sure that you use "Run as Administrator" to install and to start the game (right-click on the shortcut or setup file and select "Run as Administrator"). If you are using Galaxy, then make sure to run Galaxy as Administrator.

2) Please reinstall the game AND add it to your anti-virus/firewall software's exception/trusted list. Simply disabling the firewall or AV software could not be enough, since some of theses software are still running in the background or in the services list. If you are using Galaxy, then please add Galaxy as well.

3) Reinstall the June 2010 DirectX runtime package. You can find the archive file containing the 2010 package installation files here:
http://www.microsoft.com/en-us/download/details.aspx?id=8109

After that please download and install the DirectX Web Installer:
https://www.microsoft.com/en-us/download/details.aspx?displaylang=en&id=35

You will have to extract the files into some folder, then open that folder and launch the DXSETUP.exe file in order to proceed with the installation.

4) Maybe you have some settings forced on your graphics device in NVidia Control Panel. If so then try to reset them:
I) Right-click on your desktop and select Nvidia Control Panel.
II) Click Manage 3D Settings.
III) In the upper-right corner, click Restore Defaults.

5) Please make sure that DEP (Data Execution Prevention) is using its default setting. To do this, follow these steps:
I) Open Menu Start
II) Right click 'Computer' and click 'Properties'
III) Click 'Advanced system settings'
IV) Open tab 'Advanced' and click 'Settings' in 'Performance' section
V) Open tab 'Data Execution Prevention'
VI) Change DEP setting to the first option (Turn on DEP for essential Windows programs and services only)
VII) Confirm with OK.

6) Please make sure to unplug and/or disable all other unnecessary devices before starting the game.

7) Please make sure that no third-party applications are interfering with the game. Please try to install and run the game in “clean boot mode”. Instructions on how to do that can be found here:
http://support.microsoft.com/kb/929135
Make sure the account you create for clean boot mode is granted Administrator privileges.

If the above doesn't help maybe you have access to a different PC that meets the system requirements and that you could use to play the game?

tl.;dr