This chapter aims to provide insights into the transportation challenges encountered within humanitarian supply chains, a type of nonprofit supply chains. It offers a comprehensive overview of the transportation processes and decisions involved in humanitarian efforts, addressing both practical issues and those discussed in academic literature. Beginning with an exploration of the fundamental principles and characteristics of humanitarian supply chain management, the chapter delves into the role of transportation and the key decisions made within this context. It also highlights significant challenges associated with transportation in the humanitarian sector. Importantly, the focus of this chapter is primarily on in-country ground transportation in areas requiring assistance, spanning both immediate response and ongoing development operations. The discussion then narrows down to explore specific challenges related to transportation procurement, fleet management, and vehicle routing problems (VRPs), as studied in the humanitarian logistics literature. Through this examination, the chapter contributes to a deeper understanding of the complex dynamics and critical considerations within humanitarian transportation operations.