Seven people were transported to hospital on Sunday afternoon following a serious crash on State Highway 1 near Hunterville.
Emergency services were called to the scene that involved a truck and three cars.
A St Johns spokeswoman said five ambulances and a rescue helicopter were sent to the scene.
She confirmed that one person in a serious condition was airlifted to Palmerston North
Hospital while another person in serious condition was taken by ambulance.
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A number of people were also transported to Whanganui Hospital by ambulance.
One person was in a serious condition and another was in moderate condition.
Three other people were transported to Whanganui Hospital with minor injuries.
The road was closed around 6.40pm near Murimotu Rd, just north of Hunterville and was cleared and re-opened at 12.40am.
Police have confirmed the Serious Crash Unit has examined the scene and enquiries into the circumstances of the crash are ongoing.