Two teenage girls are being taken to Wollongong Hospital - one in a serious condition - after they were swept off rocks near Kiama blowhole on Friday.
Emergency services responded to a Triple 0 call around 1pm, with reports two girls were struggling in the water.
On arrival, paramedics discovered that a jet ski rider had rescued the pair and taken them to the boat ramp at Kiama Harbour.
NSW Ambulance Illawarra district Inspector Terry Morrow said it had been a "near drowning" situation, with both girls in the water for some time and "taking on lots of salt water".
"Both girls had been walking close to the rock ledge near the blowhole at the northern end when they were washed onto the rocks," Insp Morrow said.
"One received cuts and abrasions and a head injury, which was enough to concuss her.
"They both took on lots of salt water which we've extracted from them and we're in the process of transporting them to Wollongong Hospital.
"Both girls are stable, while the one with the head injury is more serious.
"They're both exhausted and cold."