A woman in her 60s was killed and 22 others were injured in a crash between a double-decker bus and two cars, authorities said.
Nineteen people were taken to hospital, including four who were airlifted, after the collision on Forest Road in Newport on Sunday afternoon sparked a major incident.
Hampshire Police said three other people travelling in a red Fiat Bravo with the woman who died at the scene were taken to hospital in a “serious condition”.
The bus driver, a man in his 50s who had to be cut from his cab, was also believed to have been seriously injured, while 10 of his passengers and four who were in a silver Mini Cooper were taken to hospital as a precaution.
Detectives were investigating the circumstances of the crash that happened at the junction with Betty Haunt Lane at about 12.45pm.
Bus operator Southern Vectis said it is believed the double-decker ended up in the Fiat’s path after a crash moments earlier.
General manager Richard Tyldsley said: “Early indications suggest a car pulled out in front of a route 7 bus and our driver was unable to avoid it. The bus was forced into the path of another car.
“At this stage the full circumstances of the incident are unclear but sadly I understand one of the cars’ occupants has died.
“This is very distressing for all concerned and I would like to pass our sincere condolences to their family and friends.”
The operator would assist the police and conduct its own investigation, he added.
A spokeswoman for Isle of Wight NHS Trust said a “major incident” was declared just after 1.50pm, with four people being airlifted to mainland hospitals and 15 being taken to St Mary’s Hospital in Newport.