Nine people died and 18 others were injured after the bus they were travelling in went down a bank near Hibberdene, said ER24 on Tuesday.
Spokesman Derrick Banks said in the early hours of Tuesday an SA Road Link bus apparently collided with a car on the N2 South bound near Hibberdene, 20 kilometres after Port Shepstone.
He said the driver of the bus had apparently collided with the car, causing both cars to go down a bank onto the onramp to Hibberdene.
Paramedics declared nine people dead on the scene.
Eighteen others were treated on the scene for various injuries and stabilised before being taken to various hospitals.
Sapa