Emergency services were called to the Oxley Highway at Ruby Hills Road, near Walcha, just before 12:30pm after reports of a horror crash between a rigid truck and a Suzuki hatchback.

The 22-year-old woman, who was behind the wheel of the Suzuki, and a 16-year-old girl, who was a backseat passenger, sadly died at the scene.

A 23-year-old man was sitting in the front passenger seat at the time and was fighting for life in Newcastle's John Hunter hospital on Wednesday afternoon.

He was in a critical condition when he was airlifted for specialist treatment for the chest and pelvic injuries he suffered in the crash, according to NSW Ambulance.

An eight-month-old girl was a backseat passenger in the Suzuki and was not hurt, but she was flown to John Hunter Hospital to be assessed by a specialist paediatric trauma care team.

The driver of the truck was not injured and was taken to Walcha hospital for mandatory testing.

State Emergency Service (SES) volunteers, six road ambulances and two Westpac Rescue Helicopters - each with a critical care team on board - formed part of the emergency response.

A crime scene was established and specialist police officers from the squad's crash investigation unit will be called in to try and piece together the circumstances that led to the horrific collision.

NSW Ambulance Inspector James Thompson pleaded with everyone to take care on country roads.

"This was an extremely confronting scene for all first responders, including local SES teams," he said.

The Oxley Highway remained closed into the evening between Walcha Road and the saleyards, and motorists have been urged to avoid the area.

Both lanes of the highway had reopened by 5:30pm.

A CRASH between a car and a truck has closed a highway east of Tamworth as ambulance paramedics and rescue helicopters respond.

Emergency services were urgently called to reports the two vehicles had collided on the Oxley Highway near Walcha just after 12pm on Wednesday.

Six ambulances and two rescue helicopters have been tasked to respond to the crash, with reports four people were involved, an Ambulance NSW spokesperson said.

The Oxley Highway has been closed between Walcha and Bendemeer.

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Travellers need to detour via Uralla by using the New England Highway and Thunderbolts Way.

The diversion is suitable for all types of vehicles, according to Transport for NSW.

Drivers should avoid the area near the crash scene, which is near Ruby Hills Road, and follow all directions of emergency services.

Updates on the highway closure are available on the LiveTraffic website.

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