As a counterpart to the Chevrolet Silverado, the GMC Sierra was first released on the American marketplace for the 1990 model year. This one-ton, heavy duty pickup quickly became direct competition for the Ford F-350 and Dodge's Ram 3500. Considered the luxury model of the Sierra/Silverado partnership, the GMC Sierra 3500HD 4WD is primarily used as a commercial vehicle for construction companies and others that require increased towing and hauling capabilities. With 4WD the Sierra 3500HD is also adaptable for both on and off road needs.

First available with three different trim levels, the SL, SLE, and SLT, the GMC Sierra 3500 could be outfitted with either rear-wheel drive or four-wheel drive. The model could also be fitted with quad rear wheels for extra stability during demanding towing and hauling, giving it the badge of Dually.

Significant powertrain changes did not take place until the third generation, when three different V8 engines were introduced. Also, a 6.6L Duramax turbodiesel was implemented during this generation. Over the years, the 3500HD 4WD has gained a considerable amount of horsepower, most recently topping out at around 365 horsepower.

In 2001, Motor Trend named the Sierra Heavy Duty the Truck of the Year, but since then the heavy duty version has not gotten a great deal of attention from the media. Overall, the response, both public and professional, has been mostly positive for the Sierra. However, when the model was first introduced there were concerns regarding the quality of materials used both on the exterior and interior of the pickup. Nevertheless, GMC addressed the problems and claims that there have been little to no complaints since.

While the GMC Sierra 3500HD 4WD has not gotten as much notice as its Silverado counterpart, many Hollywood feature films and television shows have used the model in scenes. Blockbuster films like Free Willy, Sweet Home Alabama, and the gender-bending Transamerica have given a role to the Sierra 3500. Television shows that have utilized the model both as a background prop and during scenes include Matlock, Smallville, Walker, Texas Ranger, and the now defunct teen drama The O.C.

Future plans for the GMC Sierra 3500HD 4WD range from a hybrid adaptation to discontinuation. The maker has yet to confirm any rumors regarding the possible discontinuation, but they point to recent hybrid additions to the line and other changes for the future as an indication that there is no intention of doing away with the Sierra.