A magnitude 6.1 earthquake has struck central Italy, levelling buildings as people slept, with one mayor saying his town "isn't here any more".
The quake struck just after 3.30 am local time and was felt across a broad section of central Italy, including the capital Rome where people in homes in the historic centre felt a long swaying followed by aftershocks.
First images of damage showed debris in the street and some collapsed buildings in towns and villages that dot much of the Umbrian countryside.
The European Mediterranean Seismological Centre put the magnitude at 6.1 and the US Geological Survey put the magnitude at 6.2 with the epicentre at Norcia, about 105 miles north east of Rome, and with a relatively shallow depth of six miles.
The hardest-hit towns were reported as Amatrice, Accumoli and Norcia, with people running into the streets as aftershocks continued into the early morning.
The mayor of Amatrice near Rieti, Sergio Pirozzi, told state-run RAI radio and Sky TG24 that people were buried under collapsed buildings, the lights had gone out and heavy equipment was needed to clear streets covered with debris.
"The town isn't here any more," he said.
The office of prime minister Matteo Renzi tweeted that heavy equipment was on its way.
In 2009, a 6.3-magnitude earthquake struck in the same region and killed more than 300 people.
The earlier earthquake struck L'Aquila in central Italy, about 55 miles south of the latest quake.
A 1997 quake killed a dozen people in the area and severely damaged one of the jewels of Umbria, the Basilica of St Francis in Assisi, filled with Giotto frescoes.
The Franciscan friars who are the custodians of the basilica reported no immediate damage from Wednesday's quake.
The mayor of the town of Accumoli said a family of four was trapped under debris without any signs of life.
Stefano Petrucci told state-run RaiNews24 that there was also another victim in the town, which is close to the epicentre of the quake.
Officials say Accumoli and Amatrice have been hit hardest by the quake.
ANSA news agency said two bodies had been pulled from the rubble in Amatrice.
As dawn broke, residents with shovels and emergency workers with bulldozers were beginning to try to reach people trapped under the debris and clear blocked roads.