Six people were killed and three were injured when a Ford Bantam lost control on the R 102 near Jeffreys Bay on Sunday afternoon, the health department said.
Eastern Cape health spokesperson Siyanda Manana said the accident happened at the Thornhill intersection towards Gamtoos around 15:30.
All nine were in the same vehicle, he said.
Two injured patients were transported to Livingstone Hospital, while a third was taken to the Humansdorp Hospital.
The cause of the accident is unknown.
All the victims are believed to come from the Thornhill area and names will only be released once the next of kin have been notified.