Five patients have been rushed to hospital after a bus crashed with another vehicle in the middle of Sydney's city centre just before peak hour.

The accident occurred on Elizabeth Street outside St James train station at about 3pm (local time) today, according to Daily Mail.

Initially the bus driver was trapped, while paramedics treated four people for injuries.

The driver was later freed, but suffered lower leg injuries, Ambulance NSW said.

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Two patients were rushed to Royal Prince Alfred Hospital and three to St Vincent's Hospital.

Images show a bus and a ute badly damaged, with a number of emergency services at the scene.