The man was killed on the R573 Old Moloto road between Marble Hall and Pretoria on Wednesday night, said ER24 spokeswoman Vanessa Jackson.
The bus driver was thought to have been trying to turn into a residential area when the bus collided with the truck.
“The driver of the bus had suffered fatal injuries and no more could be done to save his life,” she said.
The injured from both the bus and the truck were taken to nearby hospitals.
Police were investigating, said Jackson.