A 2006 Toyota 4Runner was northbound on Highway 11 when it crossed the double centerline and struck head-on a southbound 2011 Hyundai Sonata.
The driver of the 4Runner, Carol Nelson, 74, of Middlebrook, Va., was transported to UVA Medical Center for treatment of life-threatening injuries.
The driver of the Hyundai, Stacey L. Dehaven, 27, of Augusta, Va., died at the scene.
Both drivers were wearing seat belts.
The crash remains under investigation. Charges are pending.