Leggera
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Note that Serious Sam 3: BFE is more darker and adult than it's predecessors despite some humor thrown in.
The Witch Harpy, a in-game enemy, is disguised as a woman with bare breasts, but it's merely a tool to distract it's prey. Fortunately, mods can censor the nudity by adding clothing to the sensitive parts.
Grave
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The trademark Serious Sam violence is present; from enemies being shot, crushed and blown up with graphic and gory results. Blood and gore will splatter on walls and the floor, sometimes make a pool on the ground. Eventually the enemy's corpse will disintegrate, leaving a pile of ash.
A new feature allows Sam to melee kill his foes with examples like breaking their necks, but also more bloodier moves like ripping out a eyeball or heart. Blood will fly out and can splatter on the screen.
The typical red blood can be turned off or changed to a green color; but more comical blood options include enemies spewing flowers, candy and even pumpkins and carrots for blood.
Moderata
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Strong language like "fuck" and "shit" are present in the dialogue.
Nessuna
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A character makes a passing drug reference, stating that he was supposed to snort cocaine off a stripper.
Moderata
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A few levels take place in dark Egyptian tombs, with a rather creepy atmosphere.
As stated, Serious Sam 3: BFE is more darker than it's predecessors with more instances of violence, nudity and profanity.
The grotesque appearences of the enemies might scare younger players.