The fifth-wheel coupling provides the link between a semi-trailer and the towing truck, tractor unit, leading trailer or dolly. The coupling consists of a kingpin, a 2-or-3+1⁄2-inch-diameter (50.8 or 88.9 mm) vertical steel pin protruding from the bottom of the front of the semi-trailer, and a horseshoe-shaped coupling device called a fifth wheel on the rear of the towing vehicle. As the connected truck turns, the downward-facing surface of the semi-trailer (with the kingpin at the center) rotates against the upward-facing surface of the fixed fifth wheel, which does not rotate. To reduce friction, grease is applied to the surface of the fifth wheel. The configuration is sometimes called a turn-table in Australia and New Zealand, especially if it is a rotating ball-race-bearing type. The advantage of this type of coupling is towing stability.

Some camper trailers also use a fifth-wheel configuration, with the coupling installed in the bed of a pickup truck as a towing vehicle; "fifth wheel" is therefore sometimes used as a synonym for such campers.