Emergency services responded to two accidents less than 15 minutes apart and more than 30km away from each other this afternoon.
The first, a crash involving a van and car took place near the Tangoio Settlement, on SH2, about 5km south of devil's elbow.
A police spokesman said they were called at 5.10pm and there were reports two people were trapped.
A St John's ambulance spokeswoman said they transported four patients with serious injuries and one patient with minor injuries to Hawke's Bay Hospital.
She said they received the call at 5pm and six vehicles responded.
A Hawkes Bay District Health Board spokeswoman said as of this evening, three people were in a serious condition and two people were in a stable condition.
At 5.24pm, a car went off the road and "over a bank" on the Napier-Taupo Rd, about 15 minutes south of Te Pohue.
The St John's Ambulance spokeswoman said one vehicle responded to the accident.
They transported one patient with moderate injuries to Hawke's Bay Hospital.