A 30-year-old man was in serious condition at Maui Memorial Medical Center after a rescue off Hookipa Beach Park.
The Maui News reports the man became separated from his windsurfing board and appeared in distress.
Maui County Fire Services Chief Lee Mainaga says a lifeguard spotted the man having difficulty just after 3 p.m. and set off an alarm for Paia firefighters.
Mainaga says a county Ocean Safety lifeguard used a rescue board to go to the man's aid and brought him to shore.
The windsurfer was treated by lifeguards until firefighters arrived at the beach.
Firefighters transported the man over rocky shoreline and trail to medics.