The hydrogen internal combustion engine (H2ICE) truck market in North America and Europe is poised for exponential growth between 2025 and 2034. The report highlights a forecasted increase in H2ICE sales by over 61 times during this period, with an estimated 23,640 units sold across the two regions. North America is projected to contribute more than half of these sales, largely driven by the heavy-duty segment. The report attributes this growth to recent cutbacks in electric vehicle investments and higher raw material prices, which make alternative ICE vehicles like H2ICE more attractive due to their lower price premiums. H2ICE trucks require minimal modifications, offer good customer value, and can utilize existing fuel stations without significant infrastructure changes. While challenges like hydrogen availability and refueling stations persist, H2ICE trucks are deemed suitable for regional, long-haul, and heavy-duty applications. However, they may face cost competitiveness issues in the long term when compared to zero-emission vehicles as the prices of BEV and FCEV components decrease and electricity costs remain lower. The article also raises key questions about the differences between conventional ICE and hydrogen ICE trucks, the applications and use cases of H2ICE in medium and heavy-duty trucks, growth drivers and challenges, projected sales forecasts, and the comparison of H2ICE truck Total Cost of Ownership (TCO) with conventional ICE and FCEV trucks over varying timeframes.