Four children and a woman in her 30s have received life-threatening injuries in a road crash.
They included a boy aged around four years old who stopped breathing for a short time and had to be resuscitated, a girl aged around seven years old who went into cardiac arrest, a girl aged thought to be around 12 years old who needed emergency treatment by medics to stabilise her condition and a 14 year-old boy.
All of the children suffered serious head injuries, West Midlands Ambulance Service (WMAS) said.
Five ambulances, a paramedic officer and the Midlands Air Ambulance were sent for the five pedestrians who were injured in a crash in Handsworth near the junction of Grove Lane and Antrobus Road at around noon.
A WMAS spokesman said: "Crews arrived to find a car that had been in collision with a group of pedestrians."
The children were sent by ambulance to Birmingham Children's Hospital.
A woman in her 30s suffered serious head and pelvic injuries in the crash and was sent to Queen Elizabeth Hospital Major Trauma Unit for further emergency treatment
The WMAS said the hospitals had been alerted to the patients' serious injuries and trauma teams were awaiting them.
"Unfortunately the patients' injuries are considered life threatening," the spokesman said.
He added : "West Midlands Ambulance Service would like to pay tribute to its staff for their professionalism and the excellent treatment they provided at what was an extremely difficult and distressing incident. The Trust would also like to thank an off duty nurse and police officers who assisted with treatment at the scene."
Local resident Fiaz Ahmed, 33, told the Birmingham Mail: "I was upstairs in my daughter's room helping her with her homework when I heard this almighty bang and the screams.
"I ran out of the house and I could see the car and then several metres in front of it some children lying on the road. They were very badly hurt."