A 12-year-old boy suffered severe facial injuries when two school buses collided in Stanley, County Durham.
The boy was flown to the Royal Victoria Infirmary (RVI) in Newcastle, an air ambulance spokesman said.
Fifty children and two adults were on board the buses at the time of the accident.
Another child was taken to the RVI with injuries, Durham Police said, while others were treated for shock at the scene.
A spokesman for the Great North Air Ambulance Service said: "The doctor-led trauma team triaged the injured persons and a 12-year-old child was flown to the Royal Victoria Infirmary with serious facial injuries."
The accident happened at 8.20am on the A693 at the junction with Shield Row Lane close to the Oxhill Youth Centre in Stanley.
The pupils involved are from St Bede's at Lanchester and Tanfield School Comprehensive. They are aged between 11 and 18.
Superintendent Colin Williamson, of Durham Police, said: "We are currently working closely with other agencies to respond to this incident.
"The safety of those injured in the collision is our primary concern along with supporting their families.
"There will be some disruption on the roads in this area for some time and I would ask the local community to be patient while we deal with this incident."
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