Police say the accident happened around 1 a.m. along Morganton Road, near Murray Fork Drive.
It happened when the driver of a 2003 Cadillac CTS crossed into oncoming traffic, clipped a 2003 Jaguar, and then went head-on into a Dodge Caliber.
The Cadillac's driver, 69-year-old Bobby Saunders, died at Cape Fear Valley Medical Center.
The driver and passenger of the Dodge were last listed in critical condition. The driver of the Jaguar was not injured.