Just before midday, emergency services were called to a sharp bend along Scotts Head Rd where two cars had collided.
An 89-year-old man driving one car was pinned inside his vehicle and needed to be cut out by Macksville and Bowraville Fire and Rescue crews.
There were two people in the other car; one was able to step out of the vehicle before emergency services arrived, but the other was also trapped and needed help being removed.
Paramedics attended to the three people while firies worked on removing the two who were trapped.
A rescue helicopter was called, but upon arrival it was decided to transport the 89-year-old man via ambulance to Coffs Harbour Hospital. The helicopter's medical crew accompanied the man in the ambulance.
The two people in the other car were also taken to Coffs Harbour Hospital for treatment.
It is not yet known what injuries were sustained in the crash.
The road was closed for a couple of hours while fire crews worked.
But police have said that the Highway Patrol has now been replaced by local traffic control who are guiding vehicles past the crash site.
A crash investigation team is still at the scene to determine the cause of the crash.
Inspector Duty Commander MNC for Fire and Rescue, Tony Lenthall said it was a great combined effort from all agencies that attended - Fire and Rescue, paramedics, local police, RFS, and the rescue helicopter crew.
More updates as we receive them.