A man has been charged over an alleged unprovoked one-punch attack in Sydney overnight.

A 59-year-old man was walking along George Street just after 7pm on Saturday night, when he was allegedly punched once in the head by another man.

He fell backwards, hitting his head on the footpath suffering multiple facial fractures and head injuries.

The attacker fled the scene, running towards Sussex Street.

NSW paramedics treated the victim at the scene before rushing him to hospital in a serious condition, where he will be undergoing surgery today.

Police established a crime scene and launched an investigation, eventually tracking down a 37-year-old man at a nearby hotel on Sussex Street at about 3.30am.

He has been charged with reckless grievous bodily harm, refused bail to appear in Parramatta Local Court today.

Advertisement
Advertisement

The CBD light rail service was disrupted for about 30 minutes as paramedics treated the injured man.

Want more? Get more from Galey & Emily Jade