Autopsy findings on 68 fatally injured truck drivers were reviewed to ascertain severe injuries sustained upon impact with the occupant compartments. Injuries of the head, neck, chest, and abdomen in drivers of vans, pickups, and heavy trucks are discussed with some suggestions as to possible mechanisms. Findings suggest that particular attention is needed to prevent steering assembly injuries of the chest and abdomen in drivers of heavy trucks and pickups, injuries of the cervical spinal column in drivers of pickups, and head injuries of the drivers of vans. It is urged that existing knowledge of crash dynamics and occupant protection be applied to the prevention of injuries to truck occupants.