Orara Way was closed for most of the night on Friday after a serious head on crash left four people in hospital.
Just before 5:30pm, emergency services from Grafton and Woolgoolga were called to the two vehicle crash at Lanitza, south of Grafton.
According to information given to Triple M, it's understood that a Toyota Hilux driven by a 29 year old male collided with a Nissan Skyline, about 1km from Kungala Road.
The Skyline was carrying 3 people, a 23 year old driver, and two passengers aged 16 and 19.
The driver and 19 year old passenger were both trapped in the vehicle.
It took over an hour for local SES to release the 19 year old female from the vehicle.
She was airlifted with multiple internal injuries and head injuries to Lismore Base Hospital by the Westpac Life Saver Rescue Helicopter in a critical condition.
The other two occupants of the Nissan were transported by road Ambulance to Coffs Harbour Hospital.
On Saturday night the Westpac Rescue Helicopter was at Lismore Base Hospital preparing to transport the 19 year old patient to the Gold Coast University Hospital for further treatment.
Investigators from the NSW Police Crash Investigation Unit are continuing their inquiries.