In 18 Wheels of Steel: Extreme Trucker the player takes the role of a truck driver. This time, as the title suggests, the player has to drive through regions with extreme conditions: the snowy wilds of Alaska, the deserts of Australia and the Andes Mountains. The goal of every scenario is to earn enough points to unlock the next one.
Points are earned by solving missions which driving one of about 30 goods from point A to point B. Depending on the mission's difficulty level, the time and the damage due to crashes the reward is higher or lower. Then the player can choose the next missions (he always has the choice between two or more). The game features 25 trucks and an optional manual gear system. There are no managerial elements like in the other games of the series.