The deadly crash unfolded in a split second, leaving one dead and nine injured.

One person is dead and nine others injured following a terrifying 10-car pile-up on Sydney’s busy Canterbury Road at Lakemba.

The deadly crash unfolded in a split second just before midday on Tuesday when a speeding red Camry crossed into the path of oncoming traffic.

Dashcam footage captured the horrifying moment as the sedan sped down the wrong side of Canterbury Road, leaving other drivers with nowhere to go. The Camry slammed into a ute, then a van, before car after car was smashed.

The chaos began when the sedan rear-ended an SUV further up the road, sending it airborne before it mounted a bollard.

“We start to hear tyres scratching, so we look up and we’ve seen the red car. He’s come in, he’s spun this car around,” witness Tanino Aidala said.

Its bonnet crumpled, the Camry kept going, causing a nine-car pile-up seconds later.

“Crazy. Everybody, everybody’s in panic, everybody’s looking around, trying to figure out what to do,” Aidala said.

Aidala ran to help those trapped in the wreckage.

“Very, very hard to see,” he said.

Wreckage was strewn for metres, with 10 vehicles damaged and several people trapped. The elderly male driver of the red Camry died at the scene. His 78-year-old female passenger was left with critical injuries.

“They ended up cutting the side of the car, and I thought they were trying to reach the driver, but it looks like they were trying to treat the lady,” witness Joe said.

NSW Ambulance treated nine people at the scene, with three transported to hospital.

Police believe the Camry driver, aged in his 80s, may have suffered a medical episode, causing him to lose control and setting off the deadly chain of events.

Canterbury Road remained closed for more than five hours as crash investigators examined the scene and gathered evidence.

All 10 vehicles have now been cleared, and local businesses which were forced to close this afternoon will reopen as normal tomorrow.