Motorists travelling west on the M5 near Milperra experienced significant delays due to an accident involving four vehicles at about 5pm.
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All three westbound lanes are now open near Henry Lawson Drive and traffic returned to normal about 7.30pm. There had been a 15km queue back past King Georges Road.
One of three citybound lanes, which had closed, has reopened.
Emergency services and traffic crews worked on site to free trapped occupants.
Paramedics arrived at the scene of the four-car accident and assisted four patients, including two trapped inside their vehicles, a NSW Ambulance spokesman said.
One patient, male and believed to be aged in his 20s, was being treated for a head injury.
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