The accident happened on Route U about seven miles south of Maryville just before midnight.
According to the Missouri State Highway Patrol, Randy Cronk, 49, went off the road in his Ford F-250 pickup and over-corrected. At that point, he lost control and hit a tractor trailer head on.
Cronk was taken to Heartland Regional Medical Center by LifeNet, but he did not survive.
The other driver, Kelly Wilmes, 54, of Conception Junction, had minor injuries.
Wilmes was wearing his seat belt. Cronk was not.