Rowley police were not releasing the woman's name pending notification of her family. She was driving an orange Honda Element wagon with Massachusetts license plates.
The crash was the third fatal accident in Rowley since last July.
The accident took place at approximately 1:36 p.m. yesterday.
Speaking at the scene of the crash, Rowley Chief Kevin Barry said no information was available on how the accident occurred or whether the victim had been wearing a seat belt. Barry said a state police accident reconstruction team would continue investigating the accident late yesterday.
Both vehicles appeared to have stayed in their lanes, according to the chief. The point of the impact was unclear but appeared to be the left side of the Honda from front to back and the left side of the truck, the chief said. The Honda was left pointing toward the center of road, its tires deflated and its cracked windshield draped over the hood. Rowley firefighters cut open the car to free the driver, leaving its roof peeled back and pointing upward.
The truck's cargo holder fell off the bed and onto the road, and debris covered the ground between the two vehicles.
The victim was taken to the Anna Jaques Hospital in Newburyport.
About a dozen police and firefighters spent more than two hours at the site of the crash, about midway between Route 1 and Route 1A on Haverhill Street, a winding two-lane wooded road. State and Ipswich police assisted with traffic control.
The truck was carrying a propane tank that became lodged under the cargo holder, requiring responders to clear the damaged vehicle and debris carefully. The propane tank leaked immediately after the crash, and firefighters used water on the scene, according to the police chief.
The stretch of Route 133 was closed down for about two hours. Some drivers on Route 1 skirted a roadblock there through the Market Basket parking lot, and a long line of traffic waited as responders investigated and cleared the site. At one point, a woman ran past the stopped cars toward the man who had apparently driven the truck, calling his name before joining him. The man, who stayed at the scene as responders worked, declined to speak to a reporter.
A bus from the Pine Grove Elementary School was unable to make its route down the road. Principal Jennifer Roberts said police and the bus company notified the school, which held the children in the library and contacted parents to pick them up.
The two previous fatal crashes, in July and October 2005, occurred at the accident-prone intersection of Wethersfield Street and Route 1.
Last July, 90-year-old Margaret Smith was killed while attempting to make a left-hand turn onto Wethersfield street from Route 1 southbound. In October, Liz Ichizawa, a Rowley resident, was killed when she drove through a stop sign on Wethersfield Street into Route 1, where a van slammed into her driver's side door.
Police called for changes at the intersection after the first fatality, and eventually the speed limit for the section of Route 1 was lowered by 5 mph.
Correspondent Katie Curley and staff writer Stephen Tait contributed to this report.