A woman has died after a 20-car pile-up on the A40 in Oxfordshire.
South Central Ambulance Service said another woman was in a serious or life threatening condition and had been taken to the John Radcliffe Hospital in Oxford.
A man with serious injuries was taken to the same hospital.
Another 10 to 15 people with minor injuries were treated at the scene.
The ambulance service said it had been called at 8.22am, while the incident stretched more than 1km between Witney and Carterton.
A woman who saw what happened said: "I saw cars going zooming past me and trying to swerve out the way of the stationary cars but crashing into them.
"I saw one car try (to) swerve in between a Mini and another car, ending up crashing into the Mini and (flying) up in the air.
"I saw two cars swerve as they braked so hard and go flying into the barrier in the middle of the road ... it was carnage."
The pregnant mother-of-two said: "A man on his own had skidded and crashed into middle barrier.
"My partner was driving - we had to swerve out of the right lane to avoid hitting him.
"His door was open and air bags were released."
Fog had made conditions "really dangerous", she added, making it difficult to spot another vehicle until you were "on top of it".
South Central Ambulance Service spokesman David Gallagher said: "There was a collision towards the front of the queue and the more serious one about half-way down."
An air ambulance attended the scene, along with three ambulances and three rapid response vehicles, Mr Gallagher added.
Six vehicles were seriously damaged, with minor damage to another 10 to 15.
The A40 has been closed both ways.
A Thames Valley Police spokesman said: "Road closures are currently in place, and drivers are advised to avoid the area."
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