An altercation between two groups spilled out onto the street in front of a local hotel after one party was followed by the other.

Police doing foot patrol were alerted to the fight at about 2.10am Sunday morning and arrived to find two people on the ground requiring medical assistance.

The two were taken to hospital and required stitches for injuries sustained to the back of the head.

As a result four people were arrested on alcohol related offences at the scene - three males and a female.

One of the males, a 24-year-old and the female, a 21-year-old received penalty notices for public order offences while the remaining two men a 17-year-old and 20-year-old have since been re-interviewed by police and charged with more serious assault related offences.

The 20-year-old has been charged on summons while the 17-year-old has been charged and bailed with strict conditions.

Ararat police sergeant Shane Allgood said the incident has all the hallmarks of the 'one punch' scenario and that is unacceptable.

"Ararat police will be taking an absolute zero tolerance approach to any behavioural offences in the Ararat CBD," he said.

"As is so often the case it isn't the blow, but if concussed from the punch to the face an individual can fall to the ground and suffer more serious injuries from hitting their head.

"This type of behaviour is unacceptable."