The driver of the articulated truck lost control on a downhill stretch of motorway in the city of Lanzhou and crashed into the line of 31 vehicles.
It is understood 10 of the 44 people injured were in a serious condition, the Xinhua news agency reported.
Officials said another 44 people were injured in the pile-up at the toll station which is close to Lanzhou, capital of Gansu.
The truck driver, who was only slightly injured in the crash, is under police guard and is being investigated.
Drivers flouting traffic laws were blamed for nearly 90% of accidents that caused deaths or injuries that year.
The passenger, only identified as a 48-year-old woman with the surname Liu, was angry at the driver for missing her stop, police said.
However, according to China's Xinhua news, the lorry driver told authorities his brakes failed as he travelled down a hill towards the toll station.
Local authorities have demanded that unsafe sections of expressways across the province be examined.