A young girl is fighting for life after she was hit by a car on a major Sydney highway.

The five-year-old ran after a dog onto the Great Western Highway at Kingswood and was struck by a Nissan ute, paramedics were told.

The girl suffered multiple head injuries and was treated at the scene by intensive care paramedics about 4.45pm. She was rushed to Westmead Childrens Hospital in a critical condition.

Witness Sharon Dowlan, who was driving at the time, described hearing “a screech of brakes and a scream” after the girl ran out from between two parked cars.

Dowlan said traffic was travelling between 40-50 km/h at the time.

The Nissan driver, a 33-year-old man, was uninjured and taken to hospital for mandatory testing.

A young boy was also treated for shock by paramedics and was taken to Nepean Hospital, where he is in a stable condition.

Police are investigating the incident.

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