A 72-year-old man in Nanaimo suffered a medical incident while driving, which led to a six-vehicle collision, according to Nanaimo RCMP.
The driver passed away as a result of his medical incident, and his wife who was in the vehicle with him was taken to hospital in a neck brace.
Paramedics attempted to revive the man, but were unsuccessful.
Police did not immediately release the name of the man, saying the family had not been notified.
The occupants of the five other vehicles did not have serious injuries, police said.
The collision was on the Trans-Canada Highway at the Tenth Street intersection. RCMP say the call came in shortly before noon.
The Trans-Canada Highway between Haliburton and Tenth was closed southbound with a single lane open northbound while a coroner attended the scene.
It has since reopened.