Two men died on Friday morning when a passenger bus collided head-on with a car in Wadeville, Germiston, paramedics said.
ER 24 spokeswoman Vanessa Jackson said there were four men in the car and 72 people in the bus, which was transporting schoolchildren between the ages of four and 14.
"Two of the men in the car had been flung out of the vehicle following the impact. One of the men died at the scene, having been found lying a short distance from the wreckage," she said.
"The back passenger had also been killed in the collision, and he was trapped inside the wreckage, where the fire department would use the Jaws of Life to remove his remains."
Jackson said the other man was found with half his body still inside the car and the rest hanging out a window, and he had suffered critical injuries.
The driver of the car was also in a critical condition, and he required Advanced Life Support treatment, she added.
Jackson said the schoolchildren had climbed out through the windshield of the bus and were sitting near the wreckage when paramedics arrived.
"They had all suffered minor injuries except for one 14-year-old girl, who had suffered moderate injuries," she said.
"Twenty-three of the patients were loaded into a second passenger bus, and they were taken to the Germiston hospital. The remaining 49 passengers of the bus were taken to hospitals by ambulance."
The two critically injured men were taken to hospital for further medical care.
The cause of the collision would be investigated by the police.