Rescuers combed through the rubble of collapsed buildings overnight, as they searched for about 145 people missing after a magnitude 6.4 earthquake struck near the popular Taiwanese tourist city of Hualien.
At least four people were killed and 225 injured in the quake that hit near the coastal city just before midnight local time, according to the US Geological Survey.
Many of those missing were believed to be still trapped inside buildings, including a military hospital, after the quake hit about 22km northeast of Hualien on Taiwan’s east coast.
Aftershocks with a magnitude of at least 5.0 could rock the island in the next two weeks, the government said.
Japanese, Czech and mainland Chinese nationals were among the injured.
Residents waited and watched anxiously as emergency workers searched for residents trapped in apartment blocks.
Hualien is home to about 100,000 people. Its streets were buckled by the force of the quake, with around 40,000 homes left without water and around 1,900 without power.
Emergency workers surrounded a damaged residential building in the area. Windows had collapsed and the building was wedged into the ground at a 40-degree angle.
Rescuers worked their way around and through the building while residents looked on from behind cordoned-off roads. Others spoke of the panic when the earthquake struck.
Taiwan, a self-ruled island that China considers part of its territory, lies near the junction of two tectonic plates and is prone to earthquakes. An earthquake with a magnitude of 6.1 struck nearby on Sunday.
More than 100 were killed in a quake in southern Taiwan in 2016, and some Taiwanese remain scarred by a 7.6 magnitude quake that was felt across the island and killed more than 2,000 people in 1999.