After you activate Windows (or crack it/install an MSDN-provided copy that is pre-activated), you can take a look at the desktop.

The first thing you can see is the new, flat theme. For years the push has been to have completely 3D controls. Looks like that is no longer a thing.
You can also see that the only icon present on the desktop is the recycle bin. It is thankfully still possible to add the other icons back if you so desire.

The start menu now displays a pretty icon along with the user's name at the top, some of the most recently used applications on the left, as well as some icons for other things on the right.

As you can see, it is possible to add other applications to the top of the start menu by "Pinning" them. It is also possible to change the Internet and Email links to point to your defaults. Yes, it is possible to have stuff other than Internet Exploder up there! As you can see in this example, I have pinned the XP Tour program, and set Firefox as my default browser.

The right-click context menu has not changed.