Emergency services were called to the crash site about 11.30pm on Sunday at a roundabout on Wine Country Drive near Greta after reports the coach had rolled.
Initial inquiries indicated 10 people had died, 11 were injured and taken to hospital via air and road ambulances, and a further 18 passengers were uninjured, police said in a statement.
It’s understood some of the injured have been taken to Newcastle’s John Hunter Hospital, while others have been flow on to Sydney.
Media reports say the bus had been returning from a wedding reception at Lovedale.
An investigation into the crash has started, following a large-scale emergency response involving local police, rescue squad and highway patrol officers, ambulance paramedics, NSW Fire and Rescue and the Rural Fire Service.
A crime scene has been established, which will be examined by specialist forensic police and the force’s Crash Investigation Unit.
The 58-year-old bus driver has been taken to hospital under police guard for mandatory testing and assessment.
A senior NSW Ambulance officer told Seven News the magnitude of the accident had been confronting for first responders.
“Whilst they are paramedics every day of their lives, something like this is not a job that they go to every day,” she said.
“I’m incredibly proud of all the paramedics that attended. They did a fantastic job under the circumstances and no doubt they will be reflecting and we will have the right support there for them.
Wine Country Drive remains closed in both directions at Greta, west of Maitland.
Motorists are being advised they can divert around the closure via Bridge Street, Drinan Street, Clift Street and the New England Highway.
The northbound and southbound off-ramps from the Hunter Expressway to Wine Country Drive are also closed, although through lanes are not affected.
Due to the nature of the crash, the NSW Transport Management Centre says there is no forecast for how long the road will be closed.