The 7.1 magnitude quake struck at 2:20 a.m. local time, killing many of the victims while they were in bed.
Terrified residents spilled from their homes across many parts of Central America as seismic waves from the quake reached areas hundreds of miles from the epicenter.
The quake was centered beneath the Caribbean very near the Honduran islands of Roatan and Utila, where officials confirmed there were no injuries or significant damage.
Initial reports said that at least five wooden houses on stilts collapsed in three coastal towns of Belize while 25 other homes collapsed along the Honduran coast.
The shaking knocked out electricity, telephone and Internet connections across much of the affected region.
The U.S. Geological Survey reports a 4.8 magnitude aftershock jolted the region three hours after the initial quake.