Been years since I was here but taking new interest in my 2017 4 Runner. Got the oil changed yesterday and service advisor gave me list of needed maintenance items totalling $4400.00. It only has 93,000 miles so I feel like it's nearly new. Had my first in 2003 and put 164,000 miles on it with it never getting anything but oil changed. Traded it when I got the 2017 and it drives as good as the day I bought it.. I HATE the new technology on my 2022 F150 so much that I want to make this 4 Runner last forever. I will not do all the maintenance that was recommended (struts accounted for $3400.00 of that) but since I want to get 300,000 miles on this one I know I should probably plan to do quie a bit of preventative maintenance. My question is other than oil changes and air filter changes what are the most important items?

If I bought a 4Runner with 93K miles and had no record of past maintenance I would change out ALL the fluids myself: front/rear diffs, T-case, power steer, trans, brakes, coolant. The dealer would probably significantly overcharge you for this and probably not do a good job. Some I would do as successive drain/fills (Trans, power steer, coolant).

I find it almost impossible that you need struts!!!
Look up a YouTube channel called "The Car Care Nut" and find an episode he has about Toyota struts and shocks and go from there. Good luck.