Emergency services were called to Unanderra on Monday, after an incident during which a twin cab landed on the roof of a car.
The incident occurred about 2.40pm.
Ambulance NSW duty operations manager for the Illawarra, Inspector Norm Rees said a middle aged male driving on Glastonbury Avenue appeared to have had a medical episode and failed to safely negotiate the corner.
He then went through a fence and landed in a recessed/below road level car park.
"He's gone through the fence, and landed on top of a car that was parked in that car park," Inspector Rees said.
No one was injured in the incident.
According to Lake Illawarra police, the driver was taken for a breath analysis, which returned a negative result.
Inquiries are continuing.