The crash, between a van and truck, occurred just before 10am near the Tarawera Cafe.
The owner of the Tarawera Cafe, Jim Andrew, says three vans were heading north: two pulled into the public toilet area by the cafe and the third got sideswiped by a truck and trailer.
One person has been flown to Hawke's Bay Hospital in a critical condition and two others in a serious condition have been flown to Gisborne and Palmerston North hospitals.
Seven other people in a moderate condition are being transported to the three hospitals.
The road is blocked and motorists are asked to avoid the area.
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