Police are investigating the incident which happened in Lansdown Lane in Upper Weston in Bath, Somerset, just after 4pm today.
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A tipper truck carrying aggregate collided with a number of vehicles and two pedestrians as it travelled down the hill.
Early witness accounts suggest the driver was trying to avert an accident, an Avon and Somerset Police spokesman said.
“Four people have died at the scene and there are several people injured,” the force spokesman said.
“Casualties are being taken to the Royal United Hospital in Bath and Southmead Hospital in Bristol.
“We’re working with South Western Ambulance Service and Avon Fire and Rescue Service at the scene.
“The area is closed off to allow for investigative work to take place.”