Freight transport is a fundamental pillar of the global economy, facilitating the movement of products and materials essential to various industries. In this context, motor vehicles, trailers, and semi-trailers are subjected to extreme dynamic loads that lead to fatigue, deformations, and structural failures. The paper presents an overview of modern optimization methods for vehicle body structures: topology optimization, parametric optimization, and artificial intelligence-based approaches, integrated with FEM/MBD (Finite Element Method / Multibody Dynamics) modelling and experimental validation. It analyses studies demonstrating mass reductions of 7–20% and improvements in stiffness and natural frequencies through the topology optimization of truck and trailer chassis, alongside recent studies combining size optimization, surrogate models, and multi-objective genetic algorithms for various vehicle structures. Furthermore, it examines advanced materials (aluminium, CFRP composites) and multi-material solutions, manufacturing technologies (welding, 3D printing, casting, hydroforming), and the digital twin concept for real-time monitoring and online optimization. The analysis highlights major research gaps: the realistic modelling of dynamic load spectra, multi-criteria integration (mass, fatigue, buckling, fail-safe design), and the experimental validation of optimized structures. The paper argues the need for holistic, AI-assisted methodologies, fed with real-world operational data, to design safe and sustainable trucks and trailers.