It happened just after 7 pm on Sunday on Avenue 7 1/2, west of Firebaugh Boulevard.
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CHP officers say an 89-year-old man was driving west on Avenue 7 1/2 when his truck drifted into the opposite lane.
A woman in an oncoming Toyota Venza swerved to avoid the truck, and her vehicle spun off the road.
That's when the man's truck collided head-on with a Toyota Sequoia driving east.
The 89-year-old man died at the scene. The man in the Toyota Sequoia suffered minor injuries in the crash and was taken to Madera hospital for treatment.
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The woman in the Toyota Venza was not hurt.
CHP officers are still investigating the crash. They say drugs or alcohol do not appear to be factors.