The crash happened just before 7am on F.M. 3083 at Butler.
According to investigators, an eastbound Honda Civic was driving through the intersection after stopping at a stop sign when it was struck by a northbound Dodge pickup.
A back seat passenger in the car was ejected and died at the scene. He was identified as David Mejia Bonilla, 22, of Conroe.
Officials said there were two other passengers in the car -- 48-year-old Jose Aurelio Cantareno Benitez and 25-year-old Alexander Moreno.
Both of them died at the scene as well.
The driver of the car, 22, was transported to Conroe Regional Hospital in critical condition.
According to police, no one was wearing a seatbelt in either vehicle.
The 56-year-old driver of the truck walked away from the crash with a small cut on his face, officials said.
Police said he did not appear impaired and he submitted to a mandatory blood draw.