The San Francisco Medium- and Heavy-Duty Zero-Emission Vehicle (MDHD ZEV) Blueprint aims to transition 10,000 MDHD vehicles to zero-emission by 2030, aligning with the City’s ambitious Climate Action Plan2 goal of net-zero emissions in San Francisco by 2040, and the California Air Resources Board’s (CARB’s) statewide goal of 100% zero-emission MDHD on-road vehicles by 2045 where feasible. The Blueprint lays out a pathway to reduce emissions from the transportation sector, targeting MDHD, which are significant contributors to urban pollution. This report details the process of creating the MDHD ZEV Blueprint, with sections on the project’s purpose, the team’s approach, activities performed, and proposed policy solutions.