The smash happened when the Hungarian registered truck made a U turn on the highway late on Tuesday night bewteen Malmö amd Svedala, and collided head-on with two cars.
Police say one of the cars, containing a family of four, caught fire. A woman in the other vehicle also died in the collision.
The driver, who was transporting goods from Hungary, admitted drinking alcohol and told police he blacked out while on the road. He was arrested and faces charges of involuntary manslaughter, driving while intoxicated and reckless driving.