A sport-utility vehicle passed a passenger car traveling east on N.C. Highway 24, near Peavine Road, around 3:30 p.m.
That enraged the driver of the car, state Trooper H.G. Lewis said. The car driver rammed and then sideswiped the SUV, causing it to run off the road.
Four children in the SUV were treated for non-life-threatening injuries at a local hospital.
One child's injuries were severe enough to require treatment at UNC Hospitals in Chapel Hill, Lewis said. That child is expected to be released from the hospital Tuesday.
A child in the passenger car was uninjured.
Troopers charged the car driver with careless and reckless and aggressive driving. He was cited and released.
The driver's court date is pending while Lewis presents evidence to the Sampson County district attorney to determine if additional charges should be filed. The district attorney will consider if the driver should face child abuse charges.
Authorities withheld the identities of those involved in the accident while the investigation continued.