BACKGROUND: The working environment, the nature of the work, and the characteristics of truck drivers as a social group typically pose great challenges for the truck drivers’ health and health promotion activities aiming to improve it. OBJECTIVE: The purpose was to obtain a better understanding of (a) Dutch truck drivers’ perceptions of health and lifestyle themes, and (b) the challenges they experience in their pursuit of a more healthy lifestyle, as a guiding framework for the development of health interventions targeting this occupational group. METHODS:In this qualitative study,we conducted and analyzed 20 semi-structured interviews and seven cases of participant observations with Dutch truck drivers. Grounded theory was used to analyze the data. RESULTS: Our findings illustrate that Dutch truck drivers wish to improve their lifestyle but have unproductive associations with concepts of healthy living as well as a tendency to downplay their health risks. In addition, they experience barriers within their work and personal environment that prevent them from translating their intentions into actual lifestyle changes. CONCLUSIONS: Based on the insights derived from the interviews, we discuss recommendations for the development of more effective health promotion interventions for truck drivers.