An American couple involved in a fatal crash in South Waikato had been travelling on New Zealand roads for only a few days before the collision.

Sergeant Murray Hamilton, of Bay of Plenty road policing, said it appeared the rental car crossed onto the wrong side of the road and crashed head-on with a car heading east on Old Waotu Rd about 6pm yesterday, killing the female tourist.

"The rental car has come over the brow of the hill on a slight bend. The other vehicle has come out of an intersection at Old Taupo Rd," he told the Herald. "They wouldn't have seen each other to begin with, then it appears the rental car has crossed over, less than 100m from the intersection."

A mother and daughter were on their way home in the Land Cruiser, which ended up halfway up a bank off the road.

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The pair were uninjured, but were badly shaken.

The dead woman's husband was flown to Waikato Hospital and was today in a serious but stable condition.

The pair, in their 50s, had picked up their rental car in Auckland.

Alcohol and speed were not believed to be factors, Mr Hamilton said.

Waotu South Rd resident Sharon Edwards knew the intersection of Old Taupo Rd and Waotu Rd very well and said locals knew to treat it with caution due to its unusual layout.

"It's quite dangerous if you're not watching what you're doing. You come around a corner and you've got one road going straight through and one to town. And if you're not watching you can run into someone."

She hadn't heard of any crashes happening in that particular spot before.

"There probably has been but I haven't heard of any."

The Taupo Police Serious Crash Unit would be looking into whether fatigue and distraction were factors but would not have further details until after they spoke to witnesses today.

The crash occurred on a rural 100km/h stretch of road that was not a typical spot for crashes in the region, Mr Hamilton said.