Last night, a Hawke's Bay Hospital spokesperson said one female patient, in her 40s, remained in a critical condition, a male in his 60s was in a serious condition and two teenage boys were in serious but stable conditions.
Napier and Bayview volunteer fire brigades also attended.
The road was blocked while emergency services worked at the scene but was reopened by 8pm.
Motorists were asked to avoid travelling in the area, if possible.
The Serious Crash Unit is investigating and police are working to inform all next of kin.
Yesterday's fatal crash brings the region's road toll, from Wairoa to Tararua, up to 16 -
three more than the total number of fatalities for the region last year.
Earlier this month 56-year-old Trevor Paul Hampton died when the vehicle he was driving collided with a laden logging truck and trailer on State Highway 2 just north of the Hawke's Bay Airport entrance on August 2.
The stretch of highway was closed for more than two hours, with further disruption for more than an hour longer as traffic backed up more than a kilometre north of the scene, and south on Meeanee Quay through Westshore to Pandora from a closure at the HB Expressway-Watchman's Rd-Meeanee Quay intersection reconstruction.
This fatality was the first in the area in more than seven weeks since the early-morning death of a pedestrian in Wairoa on June 11.
Of the 15 previous fatalities in the Hawke's Bay districts this year, seven were drivers, three were passengers, one was a motorcyclist, two were cyclists and two were pedestrians, while most of the collisions involving cars, trucks, motorbikes and cyclists were between 7am and 7pm.