Based on the chassis of the 2011 Sierra HD trucks, the All Terrain HD features a fully boxed steel frame with exceptional strength and torsional stiffness. It incorporates the production models' new independent front suspension and asymmetrical rear leaf-spring suspensions, but with a wider 73-inch (1,853 mm) track (front and rear) that enhances stability during off-road and highway driving. A production Sierra 2500HD has front and rear tracks of 68.8 inches (1,748 mm) and 67.3 inches (1,709 mm), respectively.

An increased ride height provides greater ground clearance of 21.1 inches (536 mm) at the rockers and 11.8 inches (300 mm) at the skid plates, while specialized Fox off-road shocks deliver exceptional damping on tough terrain. They were created specially for the All Terrain HD, with specific valving. The shocks feature visible, remote fluid reservoirs - connected to the shock bodies via custom hoses - mounted in the wheel house liners and are matched with front and rear jounce shocks. They add additional compression damping and more controlled rebound, which helps increase control, stability and handling.

The All Terrain HD also features electronic disconnection of the front stabilizer bar, which enables greater crawling capability on rocky terrain. The driver simply pushes a button inside the cab to disconnect it from the front suspension.

Custom upper and lower control arms for the front suspension are designed to work with the Fox off-road shocks and jounce shocks, while supporting the greater ground clearance and ride height. They contribute to the wider track, as do the aggressive 20-inch machined aluminum all-terrain wheels. The wheels are deep, with six split-spoke elements, and are constructed in a reverse drop-flange method that ensures optimal strength. They also feature a mix of satin chrome and anodized aluminum finishes, which provide durability and a premium appearance that complements the body's Iridium Metallic color.

A full composite underbody protection system shields the All Terrain HD's transmission, drivetrain, fuel tank, exhaust system and axle differentials. It starts with the front bumper, which rolls beneath the truck and leads to a composite, integral belly pan that covers a front suspension skid plate. Protective covers are also mounted beneath the driveline components, while the front and rear differentials feature direct-mounted skid plates. The rear bumper is integrated with the rear skid plate.