Rescuers had to free a truck driver from the cab of his vehicle after a head-on crash at Salt Ash on Thursday.
Emergency services were called to Nelson Bay Road near Marsh Road just after 10am on July 23.
A spokesperson for NSW Ambulance said paramedics, an intensive care team and the Westpac Rescue Helicopter were sent to the crash site.
Two cars and a truck were involved in the collision, with one of the cars careening off the road.
According to NSW Ambulance inspector Aaron Casey it was a "significant incident, a head-on collision between a truck and a utility, with the third vehicle involved rolling down a nearby hill".
The two occupants of the first car declined medical treatment at the scene.
A woman in her 20s was driving the car which left the roadway.
She suffered minor injuries in the crash and was taken to John Hunter Hospital by ambulance.
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"One person, the truck driver, was trapped by compression," Inspector Casey said.
"It took 40 minutes for him to be freed by rescue teams, including NSW Fire and Rescue and the RFS. They had to use hydraulic rams to get the cab off his legs."
The truck driver suffered serious leg injuries in the crash and was taken to John Hunter Hospital for further treatment.
Police will investigate the cause of the crash.
Emergency crews closed the road in both directions for two hours.
Heavy traffic was reported in the area with light vehicles being diverted to Marsh Road. Heavy vehicles were being parked.
The road was reopened about 12.30pm.
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