A 6.2-magnitude earthquake hit central Italy and rescuers are searching for survivors.
At least 21 people are reported dead and many others are still trapped under rubble, reports say.
Many of the dead were in the village of Pescara del Tronto which was levelled to the ground and there were fears the number would rise. Much of the town of Amatrice was reduced to rubble.
The quake hit at 03:36 (01:36 GMT), 100km north-east of Rome.
Although it struck at a shallow depth of 10km, its intensity was compared to the Aquila earthquake in April 2009 in which 309 people died.