A young couple are lucky to be alive after they were plucked from the roof of their four-wheel-drive in the NSW Hunter region on Tuesday afternoon as rushing floodwaters surged around them.

A team of specialist paramedics pulled off the dramatic rescue, paddling into two metres of rushing water in an inflatable rescue boat.

The young couple had become stuck in rising floodwaters on Paterson Road in the township of Woodville about 2pm.

As the nearby Paterson River burst its banks and water flooded into the car, the pair were forced to climb on to the roof and call for help.

The NSW Ambulance Service paramedics – Jason Watson and Dan O'Shannessy – reached the pair only minutes before their vehicle disappeared from view.

But as the conditions intensified and the nearby Paterson River continued to overflow, the paramedics struggled desperately to get their patients to dry land.

The low-lying stretch of road was one of the first to be plunged under water at Wallalong on Tuesday afternoon as more than 600 millimetres of rain fell in 24 hours.

Footage of the dramatic rescue shows the crew paddling in vain as the current takes them well off course.

The paramedics managed to snag their craft on a large tree, take a breather and go again, this time reaching the mass of waiting emergency services.

"It's very deceptive, I would say that river is running at about five or 10 knots and you're only paddling, so it takes a bit of effort," Mr Watson said.

"If we had taken a break, that current would have taken us out of sight in a minute.

"We got the two of them on board and started paddling.

"We did all right for about the first 50 metres or so and then the wind just got hold of us and started blowing us down river and we knew we weren't going to make it back to shore.

"So we waited for a break in the wind, it backed off just a little bit and we decided to go for it and thankfully managed to get back safe and sound."

NSW Ambulance Service acting Inspector Andrew Maher said the two paramedics did an outstanding job.

"These guys actually finished a refresher course in these sort of rescues yesterday," Mr Maher said. "It was a life or death situation and the guys did a great job working together and remaining calm."

A farmer on a tractor had managed to tow a cattle truck out of the water a short time before the couple's four-wheel-drive became stranded.

Newcastle Herald