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Treyarch explains the "Realistic" difficulty setting that will be an option in Call of Duty: Black Ops 3.Then there’s the new Realistic difficulty level to take into account too. “[In Realistic] you have one point of life, so if you’re shot once, you’re dead. It completely changes the way you play the game,” says Blundell. “You all have to survive as a group. You end up respecting the level in a completely different way, and once gunfire opens up, everyone just drops to the ground, because if any one bullet hits you or a grenade goes off near you, you’re dead.” The AI too has been entirely rewritten to “make independent decisions,” he adds. “We have more types of AI than we’ve ever had before.”
If you have ever played any prior Call of Duty game before, you know full well just how near impossible it is to not get shot during those campaigns. Now it might be interesting if the enemies were also one shot kills but it's unclear right now. And this seems less of a "Realistic" name and more akin to "Insane" or "Legendary."
(via Xbox Achievements)


