Oxley police have confirmed the driver of the second car has undergone emergency surgery in a Newcastle hospital.
The 34-year-old man suffered multiple injuries, police said, and underwent surgery on Friday in John Hunter Hospital.
Police said the man was still listed in a critical condition on Friday afternoon and was receiving specialist treatment.
Investigations into the crash are continuing.
ONE man is dead and two others are in hospital after a horror start to the Easter long weekend on local roads.
The 43-year-old was killed in the crash near Attunga, on the outskirts of Tamworth, late on Thursday night.
The man was behind the wheel of a Toyota Rav 4 that was headed east along Manilla Road, past Hallsville at about 10.50pm.
Police said the Rav 4 struck an oncoming Holden Commodore near the intersection of Appleby Lane.
A 34-year-old man behind the wheel of the Commodore was trapped in the wreckage.
Emergency services worked to free the man, who was treated at the scene by paramedics.
He suffered "serious leg and other multiple injuries", a spokesperson for the Westpac Rescue Helicopter said.
The chopper airlifted the man to John Hunter Hospital in Newcastle. Police said he was in a critical condition.
A 29-year-old man, in the front passenger seat of the Rav 4, suffered minor lacerations in the crash, police said.
He was taken to Tamworth hospital in a stable condition.
The cause of the crash and the moments leading up to it are still being investigated by police.
The crash shut the road for several hours but the scene has now been cleared.
The fatal is the first on New England roads since double demerits came into force at midnight on Wednesday.