The incident, on the A49 at Woofferton at around 1.20pm, has seen the road closed between the A456 and the A4117 near Ludlow and a diversion put in place.
West Midlands Ambulance Service said that it had been called to the scene at 1.13pm.
A spokesman said that two ambulances, a paramedic officer and the Midlands Air Ambulance from Strensham attended.
Drivers of both vehicles were injured – the driver of the van seriously.
A West Midlands Ambulance Service spokeswoman said: “The driver of the van, a man, was out of the vehicle when crews arrived and was found to have sustained serious injuries.
"He was given treatment on scene before being conveyed by land ambulance on blue lights to Royal Shrewsbury Hospital for further trauma care.
“The lorry driver, a man, was treated on scene for less serious injuries and was taken to Hereford Hospital for further checks.”
West Mercia Police said officers were called to a crash near Ashford Bowdler at around 1.20pm and closed the road.
A spokesperson said one of the drivers had suffered a "serious but non-life changing injury".
Highways England said diversions have been put in place in both directions until the road was reopened at around 5.30pm.