Authorities said two people had life-threatening injuries. Among the worst injured, who were airlifted to hospitals in the region by two rescue helicopters and a Royal Flying Doctor Service plane, were two members of the Queensland Fire and Emergency Services.
The pair, who had been inside the popular local cafe, were transported to hospitals in Townsville and Cairns.
Other victims are believed to include staff, and possibly some elderly clients, of the Ravenshoe Community Centre. Among those airlifted were a 60-year-old man and a 43-year-old woman. Others were being treated for minor to moderate injuries, the ambulance service said.
There was pandemonium in Ravenshoe, in the normally tranquil Atherton Tablelands, southwest of Cairns, after the crash and explosion, which shook buildings hundreds of metres away.
As firefighters doused the flames, paramedics treated victims in the street. Eight ambulance crews were at the scene.
Police said they could not confirm reports that the ute's driver had suffered a heart attack before the collision, which tossed his car into the air and then into the cafe.
One witness said: "There were three huge bangs - it almost lifted the roof off. It felt like an earthquake."
Kate Lewis, who works in a supermarket opposite, said: "It was an absolutely horrific scene. We just heard a massive sonic boom, and went running out and saw the cafe on fire and lots of burnt people."