Forty-four people were killed when a tour bus fell off a 30-foot cliff in southwest China's mountainous region of Tibet on Saturday, the country's official news agency reported.
The bus careened after it crashed in a pileup involving a sports utility vehicle and a pickup truck on a state road in the county of Nyemo in southern Tibet, Xinhua News Agency reported.
Xinhua said 11 people injured in the crash were rushed to hospitals in the regional capital of Lhasa, and did not have life-threatening wounds.
Another five people were in the other vehicles in the accident, which happened at around 4:25 p.m. local time in Nyemo County, west of the capital Lhasa, in the Tibet Autonomous Region which is governed by China.
Photos released by Xinhua showed the bus lying upside down as rescuers worked to pull people out.
Tourism has been on the rise in the scenic Tibetan Plateau, where mountain roads are often treacherous and can be particularly dangerous in the summer rainy season.
The road where Saturday's pileup occurred had a massive landslide earlier in the week, covering a 300 yard stretch of the road in debris, according to China's weather services.
Fatal road accidents are a serious problem in China, particularly involving the country's often over-crowded long-distance buses.
In August 2012, at least 36 people died when a double-decker sleeper bus slammed into the rear of a methanol tanker and burst into flames in northern China.