A fatal accident involving a bus filled with Indian pilgrims killed at least 45 people near Saudi Arabia’s holy city of Madina, Indian police said on Monday, one of the deadliest crashes in the Gulf kingdom in years.

“The tragic bus accident involving Indian pilgrims in Saudi Arabia is deeply distressing,” VC Sajjanar, police commissioner for the city of Hyderabad, where many of the Indian citizens were reported to have come from, told reporters.

“According to preliminary information, 46 people were travelling in the bus at the time of the incident, and heartbreakingly, only one person survived,” he said.

Saudi officials have not provided a toll for the crash.

Earlier on Monday, Prime Minister Narendra Modi offered his condolences in a post on social media, saying the Indian embassy was working with Saudi officials on the ground.

“Deeply saddened by the accident in Medina involving Indian nationals. My thoughts are with the families who have lost their loved ones,” the prime minister wrote on X.

“I pray for the swift recovery of all those injured. Our Embassy in Riyadh and consulate in Jeddah are providing all possible assistance,” he added.

Road crashes were one of the greatest causes of injuries and fatalities in Saudi Arabia, according to a 2023 UN statement, which also said the kingdom had retained a high road fatality rate compared to other high-income countries.

Transporting worshippers around Saudi Arabia’s holy sites has frequently proven dangerous, particularly during the Haj, when roads can be chaotic with buses creating interminable traffic jams.

Millions also visit Saudi Arabia for the Umrah pilgrimage, which happens outside of the Haj period.

In March 2023, a bus ferrying pilgrims to the holy city of Mecca burst into flames after a collision on a bridge, killing 20 people and injuring more than two dozen others.

And in October 2019, some 35 foreigners were killed and four others injured when a bus collided with another heavy vehicle near Madina.

Pilgrimages are an essential component of Saudi Arabia’s burgeoning tourism sector that officials hope will help diversify the kingdom’s economy away from fossil fuels.

The Gulf kingdom is also home to more than two million Indian nationals who have long played a pivotal role in its labour market, helping construct many of the country’s mega-projects while sending billions of dollars in remittances back home each year.

Saudi Arabia and India have fostered a close relationship for decades.

India’s rapidly developing economy relies heavily on petroleum imports, with Saudi Arabia ranked as its third-largest supplier, according to the Indian foreign ministry.