According to police, the speeding car rammed into the autorickshaw from behind, which caused the three-wheeler in turn to hit a road-side vendor and another person.
The two on the road, along with two passengers of the autorickshaw, died on the spot, Nakrekal police station circle inspector Pravin Reddy told PTI, adding that the deceased woman was travelling in the three-wheeler.
Five others, including the driver of the car, were injured with the condition of two of them stated to be critical.
Thipparthy police have registered a case and a further probe is on into the mishap, he added.