Introduction Whole-body vibration (WBV) is associated with several adverse health and safety outcomes including low-back pain and driver fatigue. Recently introduced active suspension truck seats have been shown to reduce WBV exposures up to 50% relative to industry standard air-suspension seats, but drivers do not universally prefer these active suspension seats and their higher costs concern some companies. The objective of this study was to evaluate the efficacy of three commercially-available air-suspension truck seats for reducing truck drivers’ exposures to WBV. Methods Seventeen truck drivers operating over a standardized route were recruited for this study and three commercially available air suspension seats were evaluated. The predominant, z-axis average weighted vibration (Aw) and Vibration Dose Values (VDV) were calculated and normalized to represent eight hours of truck operation. In addition, the Seat Effective Amplitude Transmissibility (SEAT), the ratio of the seat-measured vibration divided by the floor-measured vibration, was compared across the three seats. Results One seat had significantly higher on-road WBV exposures whereas there were no differences across seats in off-road WBV exposures. The SEAT values, calculated over the whole route (which was predominantly on-road) indicated that one seat reduced WBV exposure by 9% and the other two seats by 25%. Discussion The performance differences across seats may have important practical implications for truck procurement and overall truck driver health. The higher performing seats nearly doubled the amount of time drivers could operate their trucks before reaching the daily vibration action limits recommended by the International Standards Organization. Seat suspension-based design differences are thought to account for the performance differences.