Panicked residents were sent fleeing into the streets as the powerful quake brought buildings – including a hospital – crashing to the ground early on Wednesday.
Today rescuers have been seen pulling bloodied victims to safety and frantically searching for survivors as screams can be heard from under the rubble.
The US Geological Survey said it was a 6.2 magnitude quake that hit near the town of Norcia, in the region of Umbria, at 3.36am local time.
A woman bursts into tears after been rescued from her home in Amatrice
Rescuers drag a panicked survivor from the rubble in Amatrice
Victims described “apocalyptic” scenes in towns and villages near Umbria’s capital city of Perugia – which is especially popular with British holidaymakers.
Tourists even said they felt the terrifying shock more than 100 miles away in Rome after the quake is believed to have devastated the areas of Accumoli, Amatrice, Posta and Arquata del Tronto.
Among the missing in Amatrice are believed to be six refugees from Afghanistan – Sultana and Hahmed, aged 26 and 27, three nuns and four elderly guests at a local boarding house.