Post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) are common among university students in South Africa. Despite the prevalence of common mental disorders such as PTSD and AUD, access to mental health services, especially evidence-supported trauma-focused treatments, remains limited in South African university settings. We aimed to evaluate the effectiveness, feasibility, acceptability, and appropriateness of massed prolonged exposure therapy (PE) for comorbid PTSD and AUD in a South African university setting. A single clinical case (N = 1) was screened using the PTSD Diagnostic Scale for DSM-5 (pre-intervention = 62; post-intervention = 17), clinically assessed at baseline using the Clinicians-Administered PTSD Scale for DSM-5 (pre-intervention = 60; post-intervention = 8), and the Alcohol Use Disorder Identification Test (pre-intervention = 11; post-intervention = 6). During treatment, assessment was measured by the PTSD Checklist for DSM-5 (Session 1 = 56 to Session 10 = 20). Moreover, massed PE was experienced and perceived as feasible, appropriate, and acceptable by the case participant. We discuss the effectiveness and utility of massed PE as an evidence-based treatment for PTSD and AUD, and the utility of accelerated treatments in university settings in South Africa.