Emergency services are en route to Kiama Blowhole to treat a man with suspected spinal injuries.
Early reports suggest two males jumped off rocks near the blowhole on Tuesday morning with one calling out that the other couldn't move.
It's understood the injured person is being supported by two other swimmers in the water.
Marine Rescue crews and ambulance paramedics are heading to the incident.
Fire and Rescue NSW crews are on scene.
A NSW Ambulance chopper has been called in.
More to come