Driverless trucks have the potential to contribute to a more sustainable freight transport system. However, the role of the human driver is crucial when the truck experiences a fault. This paper explores how a fault-handling system for driverless trucks can be designed to achieve high uptime and how an intelligent decision support system (DSS) can support uptime in this context. The study focuses on hub-to-hub freight transport and on the faults where the driver is presently involved. Service design methods such as field visits, semi-structured interviews, and a workshop were used. Service scenarios were developed to visualize system design considerations, and a conceptual system design is proposed. The study has resulted in an actor-network map for the fault-handling system design, a service scenario to illustrate the fault-handling process for driverless trucks, and five considerations for the proposed system design: 1) fault detection and monitoring, 2) decision-making and action, 3) information exchange, communication, and analysis, 4) information retrieval and diagnosis, 5) experience and learning. The main conclusions of this paper are that the driver’s role and activities need to be taken into account when developing new tools and services for driverless vehicle fault handling; an intelligent DSS can support humans in decision-making in fault-handling situations; a remote control center and an updated system design can help maintain uptime for driverless trucks.