It is generally provided by an emergency road service operator.

Three general types are in common usage, usually based on heavy-duty pickup or medium truck chassis:

• Hook and chain - Also known as a "sling". Chains are looped around the vehicle frame or axle, which is drawn aloft by a boom winch to rest against a pair of heavy rubberized mats so the customer's vehicle can be towed on its other axle. Slings are not used much today because they can scratch the bumpers of cars. But they are sometimes used for towing vehicles that have been in an accident or have one or two of the front or rear wheels missing or for pickup trucks and other vehicles that have steel bumpers
• Wheel-Lift - evolved from the hook and chain technology to produce a large metal yoke that can be fitted under the front or rear wheels to cradle them, drawing the front or rear end of the vehicle clear of the ground by a pneumatic or hydraulic hoist so it can be towed.
• Flatbed - (Also called a Rollback) the entire back of the truck is fitted with a bed that can be hydraulically inclined and moved to ground level, allowing the customer vehicle to be placed on it under its own power or dragged onto it by a winch.

These are the most common arrangements, but are by no means exclusive, as there are flatbed units that offer a wheel-lift, and wheel-lift units that offer a sling.

Tow trucks are usually operated by private businesses, except for major highways and toll roads, where the road authority may operate the tow trucks for that stretch of road. Businesses who operate a large fleet of vehicles, such as school bus companies or package delivery services, often own one or several tow trucks for the purposes of towing their own vehicles. Government departments with large fleets (such as the police departments, fire departments, transportation authorities and departments of public works of major cities) may similarly own tow truck(s). Police department tow trucks may also be used to impound other vehicles.