Will this radiator fit my truck's existing hose connections?

Yes—this is factory geometry, so upper and lower hose ports match OEM placement. No adapter fittings needed.

Do I need to flush the cooling system before installing this?

Flushing the old coolant is the smart move before dropping in a fresh radiator. Sediment and rust from the old core can clog a new one fast.

Does the radiator come pre-filled with coolant?

It ships empty. Fill it with your truck's factory coolant spec after installation, then bleed air from the system per your service manual.