(Guiseppe Barranco ~ The Beaumont Enterprise/AP)
The collision occurred in extremely foggy conditions at about 8 a.m. Thanksgiving Day on Interstate 10 southwest of Beaumont, a Gulf Coast city about 80 miles east of Houston.
A man and a woman were killed in a Chevy Suburban SUV crushed by a tractor trailer.
Officials at Acadian Ambulance service said at least 80 people have been taken to area hospitals with at least 10 of those critically hurt.
It wasn't immediately clear how the pileup began, but Jefferson County Sheriff's Office Deputy Rod Carroll said fog was so thick that deputies didn't realize they were dealing with multiple accidents.
Carroll said uninjured drivers helped as authorities sorted through the wreckage.
"It's just people helping people," he said. "The foremost thing in this holiday season is how other travelers were helping us when we were overwhelmed, sitting and holding, putting pressure on people that were injured."