A train collided with a truck packed with farm workers at a railway crossing near Cape Town on Monday morning, killing at least 20 people and injuring eight, paramedics said.
The workers were on the back of the truck, Netcare 911 spokesman Chris Botha said, according to the South African Press Association.
He said three people were in critical condition, while another three were described as being in serious condition.
Another two people suffered minor injuries, he said. It was not immediately known if the train driver was among the injured.
The truck was crossing the tracks when the accident happened shortly before 8 am near Somerset West, just outside Cape Town.
There was no immediate comment from Metrorail, which operates the railway.