Firefighters responded to a collision on the 400 block of Hilltop Road in Tredyffrin Township just after 10:30 a.m.
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Authorities say a man had been trapped under a red SUV for at least 30 minutes before he was freed.
It's something firefighters weren't sure would happen.
"You're expecting the worst, obviously. A car is on top of a patient, the entire car was covering the body," recalled Captain Bob Robie with the Paoli Fire Department.
Action News has learned that the driver of the vehicle was backing down a steep driveway after dropping someone off.
As he was backing up, investigators say his tires went into the grass, so he opened the door and leaned out to get a closer look.
When the driver was leaning out of the car, however, he was pulled under, police say.
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"Somehow he rolled out of the vehicle, underneath the vehicle, and it was lodged on him," said Chief Mike Beaty with Tredyffrin Township police.
Neighbors spotted the scene first, noticing that the man was underneath the SUV but alert.
When multiple emergency crews got to the scene, they said they knew it would be a delicate rescue.
"The slope of the hill required us to use all kinds of lifts, hydraulic tools, all types of pieces of equipment to stabilize the car," Beaty noted.
A tow truck driver came to help as well, hooking a cable to the car to stabilize it and protect dozens of first responders working on the steep hill.
"Now it was just going to orchestrate a very timely lift. With the cables from the tow truck, and with the airbags deployed underneath, and the hydraulic tools lifting," Beaty said.
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Inch by inch, crews lifted the 4,000-pound SUV off the man and pulled him to safety.
Video from the scene showed the man talking to first responders as they were treating him on the ground.
Crews say their training, along with help from the towing company, helped save the man's life.
"The way the situation was, we were very surprised it worked out so well," Beaty said.
The man was then rushed to the hospital for treatment where he is being held for observation. Authorities say he is expected to be ok.