Two people were killed and five people injured when two cars collided head-on outside Alkmaar, near Nelspruit, on the N4 on New Year's eve.
A man and a woman, travelling in a Toyota Tazz were declared dead on the scene. A 6-year-old child who was with them is in a serious condition.
"Two kids from the BMW had already been transported from the scene. The driver, a male, sustained only minor injuries, while an adult female was found to be in a serious condition," ER24 spokesperson Ross Campbell said in a statement.
"The injured were treated by Advanced Life Support and transported to a private hospital in the area," he added.
The South African Police Service, Fire & Rescue and Traffic police are on the scene for further investigation.
On December 20, 2018, Transport minister Blade Nzimande announced that road deaths this festive season had already increased by 16% between December 1 and 18, compared to the same period last year, bringing the total of fatalities to 767 so far.
He was speaking at the launch of the mid-festive season preliminary road safety report.