Five people have been injured following a head-on collision at Cattai.
Emergency services were called to Mitchell Park Road shortly before 4.30pm on December 28 after reports a Nissan Navara sedan and a Toyota Prado sedan had collided.
"The three occupants in the Toyota sustained serious injuries," a NSW Police statement said.
"The 33-year-old male driver was airlifted to Liverpool Hospital with internal injuries, while his front female passenger, aged 30, was airlifted to Westmead Hospital, suffering fractured ribs and internal bruising.
"The rear male passenger, aged 37, was taken to Westmead Hospital in a stable condition.
"The 21-year-old male driver of the Nissan and his 21-year-old female passenger were taken to Nepean Hospital with minor injuries."
Hawkesbury police established a crime scene, with officers from the Metropolitan Crash Investigation Unit commencing an investigation into the circumstances surrounding the incident.
Anyone who was in the area at the time of the incident and has dashcam footage is urged to come forward with information. Contact Crime Stoppers on 1800 333 000.