Caruth, who won his first career pole earlier in the day, added hours later with his first career victory by holding off Tyler Ankrum by .0851 seconds.
Caruth, 21, becomes just the second Black driver to win in the Truck Series and joins Wendell Scott and Bubba Wallace as just the third Black driver to win a NASCAR national series race.
Corey Heim appeared in command of the race when a round of green-flag pit stops got underway with 33 of 134 laps to go.
Once the cycle of stops was completed, Caruth emerged the lead with 20 laps remaining and remained in control as the race ended without another caution.
The win all-but ensures Caruth and his No. 71 Spire Motorsports Chevrolet team will compete for the 2024 Truck Series title.
“It’s surreal,” Caruth said after the race. “Thanks so much for HendrickCars.com and Mr. (Rick) Hendrick for putting me in this thing all year. I can’t thank my family enough – so many people have helped get me to this point. I can’t believe it.
“I just tried to stay cool. We lost some track position at one point in the race. We stayed in the game. It was just one step at a time. My guys got me a great (pit) stop and we just executed.
“There’s more to come, for sure.”
Heim ended up third, Taylor Gray was fourth and Christopher Bell rounded out the top five.
Completing the top-10 were Christian Eckes, Matt Crafton, Zane Smith, Grant Enfinger and Ty Majeski.
Stage 1
Majeski held off Caruth by 0.568 seconds to take the Stage 1 win. Stewart Friesen was third, Ankrum fourth and Heim rounded out the top five.
Stage 2
Majeski got around Caruth with nine of 30 laps remaining and held off Heim by 1.334 seconds to win Stage 2. Caruth ended up third, Taylor Gray fourth and Kyle Busch rounded out the top five.
Stage 3
Following the break between Stages 2 and 3, all of the lead lap trucks pit with Taylor Gray first off pit road. When the race resumed on lap 67, Gray was followed by Caruth and Majeski.
Dean Thompson slapped the wall coming off Turn 4 on the restart lap which sent trucks scrambling 4 and 5-wide down the frontstretch.
Busch had reclaimed the lead on the restart and led Majeski and Sanchez when the race resumed with 62 laps remaining.
On lap 82, Heim was able to get around Sanchez to move into the lead for the first time in the race. Majeski returned to the lead with 48 laps to go but Heim reclaimed the top spot on lap 90.
Daniel Dye and Eckes kicked off a round of green flag pit stops with 33 laps remaining as teams took on tires and fuel to make it to the end of the race.
Nick Sanchez and Majeski were caught speeding on pit road during their respective stops and had to serve pass through penalties. Busch was assessed the same penalty for a safety violation.
Once the cycle of stops was completed, Caruth moved back out to the lead with 20 laps to go.
With 10 laps remaining, Caruth had built up almost a 2-second lead over Ankrum as Heim ran third.