Officials said the accident happened just after 10 a.m. in the 7000 block of Calamar Drive in Fayetteville.
A man was trying to load a boat onto his truck when a second car hit him, leaving him pinned under the truck.
The female driver of the other car was also trapped inside.
The man was taken to Cape Fear Valley Hospital with life-threatening injuries. The woman was taken to the hospital with minor injuries.
Officials have not released either person's name.