An item delivery system can include a carrier positioned on a rail. The rail can be positioned in a delivery vehicle, for example. The carrier can include rigid or semi-rigid sidewall and dividers to form item slots. The item slots can receive one or more items. The carrier can be positioned on the rail and moved around the rail by an advancement device. The advancement device can engage with a portion of the carrier to move the carrier. The carrier can be moved to a position for removal of items from the carrier. The removal position may correspond to an area accessible from an operator area of the delivery vehicle, for example.