The North Carolina Highway Patrol said it happened on NC4, near Panacea Road, 3 miles south of Littleton around 5 p.m.
Troopers said the driver of a Range Rover SUV apparently ran off the road in a curve, overcorrected, and the vehicle overturned.
Two teens were ejected from the SUV. Troopers said only the driver, 17-year-old Anne Madeline Crone, was wearing a seatbelt.
Crone was treated and released Friday night at Halifax Regional Hospital.
Eighteen-year-old Janie Fountain was airlifted to Pit Memorial Hospital, while 17-year-old Tessa Jones was airlifted to UNC Hospital with a broken back. Seventeen-year-old Grace Barnard was taken to Wake Med with non-life threatening injuries.
The accident is still under investigation, but troopers said alcohol and speed were not factors.