In 2003, NIOSH co-sponsored a conference that brought together researchers from around the world to discuss the safety and health of commercial truck drivers. NIOSH recognizes that these workers merit attention due to the difficult and dangerous nature of their trade. Truck drivers have an unusually high rate of occupational injury, and one of the highest rates of on-the-job fatality. NIOSH is actively working to improve the safety and health of truck drivers. Current Institute projects will increase our understanding of cause-specific mortality among owner-operator truck drivers, the health effects of diesel exhaust particles, and the influence of work organization on truck driver fatigue. Reducing occupational injury and illness among truck drivers is assisted by a coordinated effort, and this conference was an important step towards establishing a national research agenda. This publication shares the information, insight, and research of the professionals who participated in the conference. Together they provide an overview of the trucking industry, summarize the current state of knowledge regarding truck driver safety and health, and document the topics for future research suggested by the conference participants. NIOSH hopes that these proceedings will be valuable to researchers, industry representatives, policymakers, and the public.