The driver involved in a fatal accident that left a woman trapped under a bus for hours in Sydney's CBD has been charged over the incident.

In January, a 51-year-old woman was struck by a bus and trapped in its axles at the intersection of Clarence and Erskine streets.

A specialist medical team was flown in by helicopter to treat the woman for extensive injuries to her lower body.

She was rushed to the Royal North Shore Hospital but died a few hours later.

The 70-year-old male driver has been charged with negligent driving occasioning death and with not giving way to a pedestrian on the road, police said.

The man will appear at the Downing Centre Local Court on July 29.

At the time of the accident, emergency services described the extraction of the woman from underneath the bus as one of the most delicate rescues in almost 40 years.

AAP