Police are now investigating the events leading up to a head-on collision near Cessnock last night.
At about 7:30pm, a Toyota Hilux and a Mitsubishi Pajero which were travelling in opposite directions, collided along Lake Road at Elrington.
The 26-year-old male driver and sole occupant of the utility suffered serious injuries, including head lacerations.
While an 18-year-old female driver had to be cut free from her vehicle.
Both have been taken to the John Hunter Hospital in a serious condition.
A male passenger was also taken to hospital as a precaution, while another passenger managed to escape injury.