Four people were killed in a head-on-collision on the R56 between Steynsburg and Middelburg on Saturday morning.
Spokesperson for Provincial traffic Charles Bramwell says the accident happened at around 5am between a Toyota Corolla and a Toyota Yaris.
Four adults in the Corolla died on the scene and a twelve year old child, who was the only survivor in the car, was taken to hospital.
Bramwell says the five people in the Yaris survived as well but sustained serious injuries.
He says the Corolla was travelling in the direction of Middelburg (direction Cape Town) and the Yaris was travelling in the direction of Steynsburg.
Police are investigating a case of culpable homicide.