Witnesses called 111 saying they had seen two people in the water.
Fire and Emergency and St John Ambulance also attended and the man was taken to Waikato Hospital.
The woman was given an hour of CPR at the scene, police said.
Andrew Mackintosh was passing about five minutes after the crash and saw emergency services performing CPR before carrying the people up the bank to three waiting ambulances.
It appeared the car "hit a kerb, gone almost airborne, gone over the barrier, down the bank and into the water", Mackintosh said.
He said a crowd of up to 100 people had stopped to watch, delaying traffic in Cambridge.
Diversions are in place at the intersections of State Highway 1 and Tirau Rd, Cook St and Shakespeare St, and Achilles Ave and Dominion Ave, while the Serious Crash Unit investigates.