Forty five homes in Stuart Point were forced to evacuate overnight after a septic tank burst.
The incident was triggered by the recent floods and caused the sewage to overflow into yards and streets.
Police have warned residents could be kept away from the area for as long as seven to 10 days.
NSW Health is treating it as a public health risk due to the risk of faecal matter and bacteria.
Led by Fire and Rescue, residents were given gumboots and hosed before being bussed to a nearby youth centre in Yarrahapinni.
Police are currently stopping cars outside the entrance of the main street and alerting further residents to evacuate.
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