The men, aged 36 and 41, were found critically injured in North Nowra at 7pm on Wednesday.
Police believe the two were lying on the ground on Condie Crescent when they were run over by the ute.
A 27-year-old male was allegedly driving the car.
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Bystanders provided first aid until paramedics arrived, but both men died at the scene, police said.
The driver has been taken to hospital to undergo mandatory testing.
Crash investigators are now trying to determine what happened.