A North Shore woman fell 20 to 30 feet into the ocean from a ledge at the mouth of Hanauma Bay and was rescued by a fisherman, officials said.

The incident happened at about 9:20 a.m. near “Baboon’s Nose,” a rock formation on the south outside edge of the bay, which is not visible to lifeguards. Public access to the area is restricted.

A spokeswoman for the Ocean Safety Division said lifeguards responded on paddleboards and personal watercraft and stabilized the woman on a backboard until the Honolulu Fire Department’s rescue helicopter arrived and airlifted the woman to the Koko Head Shooting Range.

An ambulance crew treated the woman for a head injury and abrasions. She also swallowed ocean water.

The woman was in serious condition when emergency crews took her to the hospital.