I have been waiting to jump into me second play through. I would really like to up the challenge and the realism. I know there has been a lot of talk about what people want, but what realism type mods are actually available right now?

Realism's a tough word to use when looking for mods for a fantasy game.

What do you mean by realism?

I guess stuff that would resemble hardcoe mode from new vegas.. Even maybe removing the compass, harder end game, no regenerating health, etc..

http://www.skyrimnexus.com/downloads/file.php?id=3942 - Carrot approach to food
http://www.skyrimnexus.com/downloads/file.php?id=3135 - Stick approach to food and sleep
http://www.skyrimnexus.com/downloads/file.php?id=3222 - customize your HUD

http://www.skyrimnexus.com/downloads/file.php?id=1269- makes AI smarter and does a lot of other things, that seem realistic to me.
These console commands eliminate regen if you don't consume a regen potion:

player.modav magickaratemult -100player.modav healratemult -100player.modav Staminaratemult -100player.modav healrate +2.3

I've not looked in to the script functions yet (is the wiki even available yet?), so this is all just rolling around in my head....
but....

after almost 3 years of working on Vim & Vigor for Oblivion, I plan on making an eat/drink/sleep mod for Skyrim.

So, yeah... I'm sure others are planning the same, so as soon as the CK is released, and the wiki comes on line.... I'm pretty sure the realism mods will flood the forum.

Thanks guys.

Look forward to your mod Ssenkrad.

A better lighting mod would usefull... no light sources without a visible source, light sources have a smaller lighting area, when ouside the lighting is darker when it's cloudy and grayer but still bright when in a snowy place.

And multiple usable lighting source mod... It could do like Morrowind...Have more usable light sources than magic and torches.

http://www.skyrimnexus.com/downloads/file.php?id=3562 lets you interact with (Grab/Drop/Move) a bunch (87) of MSTT (Moveable Static) forms which normally can only be knocked around by walking into 'em or moved with a fireball. Soon after the CK is out, it will be replaced with More Interactive Items which will also allow putting these items in your inventory and buying/selling of 'em. I guess it would probably fall under the 'realism' category since, if you were really there, you could grab pots, crates, bones, animal parts, etc.

Also, it's my first mod to utilize Skyrim's localization strings, so one plugin works for five languages.

Not now, but soon.

I've begun work on my Skyrim Realism Tweaks (will be somewhat similar to my http://arwenevecom.ipage.com/Fallout/FO-mods04.htm.

The focus on my Realism Tweaks [ART] has always been to make the game a better RPG, while also making the game MUCH more challenging. I will also be attempting to make this game more realistic (within Skyrim's fantasy word), but a better word would probably be immersion. And I will be including NEEDs.

So far my Tweaks are in beta (not yet release), and limited to what I can improve through changes to Game Play values (which has already improved my own game quite a bit). . . but I need to be able to add scripts before I can make most the changes that I have plans for.

Have you checked out Realistic lighting? Not sure if you've seen it, and of course it's not in everyone's tastes, but you may be interested in it. Alternatively, No Tint and Desaturation has options for darker interiors/darker nights, and it's well thought of by most I've seen. The author's improved his packaging (afaik), so I'd go ahead and vouch for it now.

Realistic Lighting:
http://www.skyrimnexus.com/downloads/file.php?id=4323
No Tint and Desaturation:
http://www.skyrimnexus.com/downloads/file.php?id=648

Well, Arwen I cant wait til your realism mod is released. I am a long time fan and must say that your realism mod is the most thought through "realism" mod for a hardcoe fan like me. Could not imagine to play FO3 or FNV without it. Loved the added challenge and immersion. Keep up the excellent work, you are very talented.

For the OP I can recommend using Wiz0floyd′s suggestions. I use one of the food mods with PISEs AI module and the recommended console commands for an added challenge and immersion. My character is a nord brute warrior who does not use magic or enchanting and has virtually no regen. I set health regen to 0.1 so it takes quite some time to replenish e.g. health. Normally I replenish health with the various craftable foods or potions. I also only use armor that I think is in character i.e. mostly light fur armor. This has really increased the challenge of my gameplay in a positve way. Every battle is interesting and I often die if I am careless. Early on there also was a camping gear mod released (portable camp village - cant find it anymore though) that let you spawn a regular fire, chair, tent, cooking fire and bedroll. It will do the job til the CK comes out. I also enjoy the cooking recepie pack for some more "powerful" foods: http://www.skyrimnexus.com/downloads/file.php?id=1368

For general immersion/hardcoe mods I recommend:
Phitts excellent Cutthroat merchants: http://www.skyrimnexus.com/downloads/file.php?id=2762
Tougher traps or Deadly traps and sickly diseases: http://www.skyrimnexus.com/downloads/file.php?id=2905
No fast travel: http://www.skyrimnexus.com/downloads/file.php?id=2075
Ish weighted gold: http://www.skyrimnexus.com/downloads/file.php?id=650
Subliminal traps: http://www.skyrimnexus.com/downloads/file.php?id=2653
Sneak rebalance or similar: http://www.skyrimnexus.com/downloads/file.php?id=819

Also, if you have time. Browse though Deltes immersion thread. It has some interesting discussions on the topic.

No.. it's not at all. Not to those of us who can think outside the box anyhow.

I think the best way to make it a better RPG is to look at choices and consequences and have the world react to what your character does, like new Vegas did.
Eating, sleeping, washing, and better combat mods are all well and good and a lot of fun but they don't immerse you in the world as much as actually having a reactive environment that acknowledges the events that your character takes part in .

Case in point, I won the war with the storm cloaks however It's hard for me suspended my disbelief when after wards I kept bumping into Imperials on the roads afterwards and the imperila barracks in Dragon bridge was still their along with many wilderness camps complete with immortal named characters.

YES!!! Can't wait for your realism tweaks, loved the new vegas ones!

I thoroughly enjoyed your work on Fallout and I look forward to what you bring to the table for Skyrim.

Might I offer a suggestion though?

A need to piss.