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Promoting the use of zero-emission vehicles is an important measure for reducing pollutant and carbon dioxide emissions from medium- and heavy-duty trucks (MHDTs). This study took Hainan Island as an example. Based on big data such as industrial layout and traffic flow, it clarified that the main channels of freight transportation on Hainan Island are concentrated in the northern region, including the surrounding areas of Haikou; the important ports of Haikou, Yangpu, and Basuo; and Chengmai and Tunchang counties. Furthermore, pathways for the promotion of zero-emission MHDTs are proposed, which can reduce exhaust emissions by 1549 tons of NOx, 62 tons of particulate matter (PM), and 3.60 million tons of CO₂ by 2030. Compared with the vehicle type categorization plan, the spatial layout plan can achieve higher emission reduction benefits in the medium term (2025). In addition, in conjunction with existing policies and planning requirements, this study also puts forward policy suggestions for the promotion of zero-emission MHDTs.