The youngster, who was in a pram, was being pushed across a busy road in Huzhou City, east China when the lorry approached at high speed.
Surveillance cameras show it going right over the pram as the driver tries to stop.
He then jumps from his cab and pulls the boy from between the wheels of the truck and hands him back to his mother.
Police said the driver had failed to notice a red light and had told them he was tired “after over two hours of driving”.
Despite the horrific nature of the accident, which happened on Thursday, the boy is reported to have only minor injuries.
The truck driver, who accepted responsibility, was fined 150 yuan and given six points on his licence.