Just before midnight, emergency services were called to the New England Highway at Liddell.
They found two cars had collided, followed by a truck hitting both vehicles.
The male driver of a green sedan died at the scene. He is yet to be formally identified.
The female driver of a silver sedan, aged 22, was trapped and had to be freed from the wreckage.
She was treated at the scene before she was airlifted to hospital in a serious condition.
The truck driver, a man believed to be aged in his 40s, was unhurt and taken to hospital for mandatory testing.
An investigation is underway and a report will be prepared for the coroner.
