A man in his 40s has been airlifted to St George Hospital with serious head injuries following a two-vehicle crash at Fairy Meadow on Tuesday morning.
The 45-year-old was the driver and sole occupant of a small Mitsubishi SUV that collided with a Toyota Hilux ute in the southbound lanes of Memorial Drive at the Elliotts Road overpass about 10.15am.
The man was trapped for some time before he was freed from his vehicle and treated at the scene by paramedics.
NSW Ambulance duty operations manager, Inspector Norm Rees, said the man had a reduced level of consciousness and was "combative", and had to be sedated and intubated at the scene.
He was then transferred to the Toll Ambulance Rescue Helicopter, which landed on Memorial Drive, and flown to hospital.
Inspector Rees said the man was in a serious and unstable condition when he left the scene.
The driver of the ute escaped the crash unharmed.
"I'd like to thank everybody - the Fire [and] Rescue, traffic authority, police - everybody works together collaboratively, it makes it really easy and simple and safe," Inspector Rees said.
The southbound lanes of the highway were closed for some time while the patient was treated and the scene was cleared.
The police investigation into the crash is ongoing.