Rather than try to explain it myself(don't want to type that much, lol), this guy gives three options, main thing you need to start with is which cylinder is #1.

Does it still have the EGR valve? Recently had some issues with mine and similar symptoms.

Throw out your questions, folks are here to help! (y)

Good luck with that tranny!We had the C4 in our 77 rebuilt way back. It was interesting pulling that thing out with the truck sitting on the ground(think dirt and gravel) but I was doing it by myself and really had no choice. Being low allowed...

Good looking truck!

Welcome! Post up pics of your truck when you get a chance, would love to see it!

Have you done any tuning of the idle mixture? Might be worth putting a vacuum gauge on it to make sure it's not running too rich.

Glad you got it figured out!

Yeah, I've tried reconditioning as well and it a helped a little but I had let them go too long so new headlights it is. Sure is nice to be able to see at night, lol.

Keep at it and let us know what it takes to get it going, love hearing progress on these projects. (y)

That is indeed a nice truck, amazing original condition!

Hey there, can you clarify the specs on your truck? That part number didn't match for the search I did on 1993 F150, maybe because I don't know the engine/tranny combo. :)

Welcome to the forum!