The accident happened around 5:30 a.m. Thursday, about eight miles west of Lillington.
The driver of the car, 45-year old Gene Taitt, was killed. The truck driver, who was hauling trash, walked away with scrapes and bruises.
Troopers and emergency workers call the accident one of the worst they have ever seen on 421. Body parts and pieces of the car involved were spread throughout the roadway.
"This vehicle evidently came over in his lane and when he did, he tried to take evasive action to avoid hitting him," said Trooper John Bobbitt.
But the truck driver said he could not avoid the oncoming car. He hit the driver's side of the car and dragged the car several hundred feet.
Because several pairs of shoes and clothing were scattered around the vehicle, officials thought there might be more victims inside the mangled wreckage. There were not.
Troopers are now trying to figure out why the victim crossed the center line. They say the driver of the truck will not be charged in the accident.
Motorists traveling U.S. 421 just west of Lillington had to use an alternate route until the wreck was cleared around 1 p.m.