The Westpac Rescue Helicopter was called to a single vehicle rollover on the New England Highway on Thursday.
The crash occurred south of the Kentucky turnoff, approximately 17 kilometres south of Uralla and the highway was initially closed both ways while emergency services and traffic crews were on site.
The driver of the car, a young female, has been taken to the Armidale Hospital by road ambulance with minor injuries.
The male passenger, a man in his 70s, was trapped in the vehicle for some time.
He was treated and stabilised at the scene by the helicopter medical crew and road ambulance paramedics.
He has sustained possible pelvic injuries and multiple lacerations in the accident and is being transported to the Tamworth Rural Referral Hospital in a serious condition.
Live Traffic NSW is advising that traffic is affected in both directions and for motorists to expect delays.