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An elderly woman is critically ill in hospital following a serious crash on a slip-road of the Thanet Way.
Two pensioners were cut free from the wreckage of a blue Vauxhall Meriva after it collided with a black Range Rover at the junction with Church Lane in Whitstable.
The drivers of both vehicles and a passenger of the Range Rover were taken to local hospitals with minor injuries.
A fourth person, an 82-year old woman from Medway, has been taken to a London hospital where she remains in a critical condition.
Fire crews were forced to cut its roof off the Vauxhall to reach the pair, who were seen being removed on stretchers from the car, which landed in a nearby hedge.
Five ambulances and two fire engines were among the emergency vehicles called to the scene.
A critical care paramedic was also in attendance.
The smash sparked queues along the slip-road, with Church Lane closed off.
The front end of the black Range Rover suffered extensive damage.
Police say two pensioners who were in the 4x4 were taken to hospital with "minor injuries".
A Labrador seen in the back of it was taken away by police.
Detective Sergeant Chris Wade from the Serious Collision Investigation Unit said: "We are keent to speak to anyone who has not yet spoken with police, who saw the collision or the Vauxhall Meriva prior to the collision."