The crash happened Friday evening around 8 p.m. on Highway 158 near the Des Continuations rural road in St-Jacques. The road is an undivided highway.
The driver of one of the vehicles swerved into the oncoming car and hit it head-on. A third vehicle then struck the other two.
The driver of the second car was killed. Four passengers were injured in the crash.
Hydraulic equipment was used to pry the passengers out of the first two vehicles.
Provincial police are investigating to determine the cause of the crash. Falling asleep at the wheel is one of the hypotheses which police are studying.