European Commission President Ursula von der Leyen has said those responsible for the missile attack on the hospital in Gaza must be held responsible.
She stopped short of blaming either side for the atrocity, but said that Hamas had plunged Israel and Palestine into a new spiral of violence.
She told MEPs in Strasbourg: "The scenes from Al Ahli hospital are horrifying and distressing. There is no excuse for hitting a hospital full of civilians. All facts need to be established, and those responsible must be held accountable."
President von der Leyen said all sides had to redouble efforts to protect civilians.
The European Commission president has faced criticism over her visit to Israel in the wake of the Hamas attacks on 7 October, and her failure to immediately call on Israel to respond within the bounds of international humanitarian law.
Speaking in the European Parliament, she defended her visit.
"I believe it was important to pass this message of solidarity in person, in Israel, just days after the Hamas attack.
"Only if we acknowledge Israel’s pain, and its right to defend itself, will we have the credibility to say that Israel should react as a democracy, in line with international humanitarian law.
She said that despite a tripling of humanitarian aid to Palestinians and the establishment of an air bridge to bring supplies to Egypt, it was important that support for Palestine remained "under review".
She said: "EU funding has never gone to Hamas or any terrorist entity and it never will."
Ms von der Leyen warned against the rise in hate speech and physical attacks in Europe as a result of the spiral of violence in the Middle East and said that Jewish life must be protected.
"It is our shared responsibility to make sure that our dark past does not return," she told MEPs.
She said the Digital Services Act, which has recently come into force, allowed the authorities to take down illegal content and contain the spread of disinformation.
"We have already launched an investigation in relation to X, formerly known as Twitter. They must comply with the obligation to counter the spread of terrorist propaganda and hate speech."
