Following a tense tiebreak, Ramphadi and Sithole overcame Brazilians Leandro Pena and Ymanitu Silva 6-2 4-6 10-8 in the bronze medal match to take South Africa's medal tally to four.
Dutch duo Niels Vink and Sam Schroder won the gold medal match after defeating Britain's Andy Lapthorne and Greg Slade 6-1 6-1.
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Ramphadi, 31, who developed brittle bone disease at 12, won the French Open doubles last year with Lapthorne and was a finalist in doubles at the last two editions of the Australian Open.
"This venue is something special. Last year I won my first Grand Slam here on my birthday, now I have a Paralympic bronze medal. For me, to be here and winning a medal is crazy – I am just going to enjoy the moment," Ramphadi said.
Sithole, 37, who lost his legs in a train accident at age 12, won the U.S. Open singles in 2013 and the Australian Open doubles three years later.
“It is our first big medal playing together and we’re very happy to write history," Sithole said.
"I was so happy to play with Donald today. He brought his A-game, even though he was nervous and made double faults – he owes me a whiskey... We were here to win today, not just represent.”
(Reporting by Shifa Jahan in Bengaluru; Editing by Toby Davis)
Lucas Sithole and Donald Ramphadi of Team South Africa celebrate after winning the Tie-Break during the Men's Quad Doubles Bronze Medal Match against Leandro Pena and Ymanitu Silva of Team Brazil on day seven of the Paris 2024 Summer Paralympic Games at Roland Garros on September 04, 2024 in Paris, France. (Photo by Alex Davidson/Getty Images)