Four children and one adult were killed in an accident between two vehicles on the N14 near the Wierda on-ramp in Centurion, Pretoria on Saturday afternoon.
ER 24's Werner Vermaak says paramedics found one of the vehicles completely torn apart.
He says all the occupants were ejected from the vehicle during the impact.
Vermaak says four young children and an adult were declared dead at the scene.
Two women from the same vehicle sustained moderate injuries and were later transported to a nearby hospital.
Vermaak says the male driver of the other car sustained moderate injuries and was treated at the scene before being transported to a nearby hospital.
The cause of the accident is not known, and police are investigating.