Truck Driver places players in the role of a new trucker in an open world, inheriting a vehicle and aiming to build a career. The core gameplay loop involves hauling various types of cargo for a diverse range of clients, from construction workers to lumberjacks, to gain respect within the local community. Players can personalize their trucks by selecting from numerous parts and tuning them to their preferences.

The simulation includes a Hidden Places & Damage System, adding depth to the driving and exploration. The game focuses on the player's career progression and building relationships through completing jobs.