The airport tunnel, where a young woman was killed in a head-on crash last week, has a poor accident record.
Leidy Rincon, 29, was a back seat passenger in a Honda CVR which collided with a Ford Falcon about 5.40am.
The Honda was travelling north in the contra flow lane in the southbound tunnel. The Falcon was in the same lane, heading south
Ms Rincon died at the scene. The other occupants of the Honda, as well as the Falcon driver, were also seriously injured.
Police are investigating the crash. No charges have yet been laid.
Transport for NSW declined to comment until the investigation is complete.
The contra flow lane in the morning peak, which is designated by lights but has no physical barrier, was introduced when the M5 East opened in 2001.
Transport for NSW figures reveal, since 2014, there have been 49 crashes where at least one person was injured or killed along the stretch of General Holmes Drive from the M5 merge through the tunnel and then to where the contra flow lane merges back to the northbound traffic
There have been two fatal crashes, one of which occurred last week, 12 serious injury crashes, 22 moderate injury crashes, 12 minor / other injury crashes and one uncategorised injury crash.
These crashes have resulted in two fatalities, 16 serious injuries, 28 moderate injuries, 18 minor / other injuries and three uncategorised injuries.
The figures are said to be approximate because of difficulties accurately locating crashes in and around tunnels.
The 2014 to 2018 data is final, with 2019 data estimated to be about 75 per cent complete, but only the first two quarters have been linked to the health data.
The 2020 data covers fatal crashes up to midnight on February 6, 2020.
Data for 2019 and 2020 are preliminary and are subject to change.
