The Princes Highway near Tomerong is closed after a serious accident south of Hawken Road.
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A southbound Toyota Hilux crossed to the wrong side of the road and collided with the trailer of a semi trailer.
The Hilux rolled, and its driver was trapped for a short period of time.
Ambulance paramedics released him and he managed to crawl from the vehicle.
The driver suffered a broken femur and head injuries. He has been taken to Shoalhaven Hospital and will be airlifted to a Sydney hospital.
The highway is still blocked in both directions.
Southbound traffic is being diverted via Hawken Road and northbound traffic onto Island Point Road.