The incident occurred about 11.30am on Monday at a shopping mall in Revesby, with emergency services called to reports a pedestrian had been hit by a vehicle.
The woman, believed to be in her 70s, was treated at the scene by NSW Ambulance paramedics before being taken to Liverpool Hospital in a serious condition.
Police have established a crime scene at the location with officers from Bankstown Police Area Command conducting inquiries into the circumstances surrounding the incident.
The driver of the vehicle, a woman believed to be in her 60s, was uninjured and was taken to Bankstown Hospital for mandatory testing.
Police have urged anyone with information about this incident to contact Crime Stoppers on 1800 333 000 or https://nsw.crimestoppers.com.au.
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