Panicked survivors ran into the street screaming as the 6.4 magnitude temblor rocked western Pakistan’s city of Quetta and at least eight other villages.
Wrecked buildings left an estimated 15,000 people homeless at the onset of winter in Baluchistan, a remote province on the border with Afghanistan.
Worst-hit was the former British colonial hilltop resort of Ziarat and surrounding villages, where hundreds of houses were destroyed, including some buried in landslides triggered by the quake.
The U.S. Geological Survey determined the quake struck the valley of Ziarat at 5:10 a.m. local time about 35 miles (60 km) north-northeast of Quetta, the capital of Baluchistan.
Reporters in that city said a constant stream of survivors was arriving on foot from the worst-affected areas. Hospitals reported that they were stretched beyond capacity while trying to treat the injured.
Aftershocks continued to rattle the region for the remainder of Wednesday, but there were no reports of additional casualities of damage from the ongoing seismic activity.