A suspected drunk driver mounted the kerb close to New York's Times Square and drove for three blocks smashing into pedestrians.
An 18-year-old girl who was walking on the pavement with her 13-year-old sister was fatally injured.
The younger girl is one of 22 people hurt - many of them left with open fractures and major trauma.
The suspect, Richard Rojas, 26, is said to have performed a u-turn and driven at speed against the flow of traffic toward one of the world's most popular tourist spots.
The car finally hit a metal post, becoming wedged partly on its side, and the suspect jumped out of the vehicle.
As he attempted to flee, police and several members of the public brought him down.
A picture of the suspect on the TMZ website appears to show him in a rage in the moments after the car is stopped.
Another on the site shows him with a ripped t-shirt after he is subdued and surrounded by police officers.
City authorities say they have no reason to suspect terrorism.
They say Rojas has a record of drink driving and is currently being tested for alcohol and drugs.
Four are in a critical condition, three are serious and the other 15 also had to be treated for their injuries.
New York Police Department Assistant Chief William Aubry said the incident started at 11.54am local time when Rojas's Honda Accord was seen travelling southbound on 7th Avenue in the direction of 42nd Street.
Mr Aubry said: "He makes a u-turn on to the westside sidewalk between 7th Avenue and 42nd Street, proceeds on the westside sidewalk for three and a half blocks where he hits a stanchion.
"Between 42nd and 43rd, an 18-year-old female was struck and is now dead.
"Her 13-year-old sister was also struck and she is being treated in hospital.
"Upwards of over 20 other people were injured between 42nd and 45th Street on that sidewalk.
"When he hits the stanchion, there is a traffic agent that ends up tackling him.
"Right now he is being transported to a testing facility where a highway (cop) will test him for drugs and alcohol."
He said he had been held in 2008 in Queens and in 2015 in Manhattan for drinking and driving and in May for "menacing".
New York mayor Bill de Blasio said the suspect is a former US Navy serviceman and a US citizen and confirmed terrorism is not suspected.
Witnesses described seeing people being loaded on to stretchers, shoes scattered around the scene and people in bloodstained blankets.
One picture showed what appeared to be the dead woman in the middle of a pedestrianised area with a broken off wing mirror lying next to her.
Others nearby on the ground are being tended to by passers-by.
Witness, Juan Soto, told Sky News: "I came upon the scene - a gruesome scene with multiple victims on the sidewalk and the street.
"I saw the head injuries and the blood and the victims not moving; I realised… that a car had ran into the crowd just minutes before."
The White House says that President Trump has been "made aware" of what has happened.
More than 300,000 people pass through Times Square every day.