Three people, including two children, were killed and seven others injured after a bakkie and a light motor vehicle collided on Thursday.
The accident happened along the N8 Tweespruit crossing in the Free State.
ER24 spokesperson Russel Meiring said their paramedics arrived on the scene to find the two vehicles in the middle of the crossing.
"The provincial EMS was already on the scene assessing the patients. On closer inspection, medics found a four-year-old boy and a 10-year-old girl lying outside the light motor vehicle. Unfortunately, the children had already succumbed to their numerous injuries.
"Eight other patients were tended to on the scene. A woman was found in a critical condition, while seven other patients, including a five-year-old boy, were found with minor to moderate injuries," said Meiring.
The injured patients were treated and the critically injured woman was provided with advanced life support interventions before being transported to nearby hospitals for urgent care.
"Unfortunately, on arrival at the hospital, the critically injured woman succumbed to her injuries."
Police are investigating the circumstances of the accident.