Five people were killed and three more injured in a head-on collision between a BMW and a Toyota Corolla on the N3 in Van Reenen on Sunday afternoon.
ER24 spokerperson Annine Siddall said at about 4.15pm, ER24 paramedics arrived at the scene and found a boy, believed to be 11 years old, on the back seat of the BMW.
He was in a critical condition and was transported to the Laverna Hospital in Ladysmith for further medical care.
Two more people in the BMW had sustained moderate injuries, said Siddall.
She said five people who were travelling in the Toyota Corolla were declared dead by other emergency services on the scene.
The exact circumstances surrounding the collision were not yet known but local authorities were on scene.
Meanwhile one person sustained moderate injuries and two more sustained minor injuries in a head-on collision between a taxi and car on Shepstone road in Pinetown during the early hours of Sunday morning.
ER24 said one person had to be freed by Fire and Rescue personnel after being entrapped in the car.