The epicentre of Tuesday's magnitude 6.8 quake, one of the region's most powerful tremors in recent years, was in Tingri in Tibet, about 80 km north of Mount Everest, the world's highest mountain. It also shook buildings in neighbouring Nepal, Bhutan and India.
At least 126 people were known to have been killed and 188 injured on the Tibetan side, state broadcaster CCTV reported.
Temperatures have dropped as low as minus 18 C with any survivors at grave risk of hypothermia. (AP PHOTO)
Twenty-four hours after the tremor struck, those trapped under rubble would have endured a night in sub-zero temperatures, adding to the pressure on rescuers looking for survivors in an area the size of Cambodia.
Temperatures in the high-altitude region dropped as low as minus 18 degrees Celsius overnight. People trapped or those without shelter are at risk of rapid hypothermia and may only be able to live for five to 10 hours even if uninjured, experts say.
Chinese authorities have yet to announce how many people are still missing. In Nepal, an official told Reuters the quake destroyed a school building in a village near Mount Everest, which straddles the Nepali-Tibetan border, but no one was inside at the time.
Jost Kobusch, a German climber, said he was just above the Everest base camp on the Nepali side when the quake struck. His tent shook violently and he said he saw several avalanches crash down, although he was unscathed.
"I'm climbing Everest in the winter by myself and...looks like basically I'm the only mountaineer there, in the base camp there's nobody," he told Reuters in a video call.
His expedition organising company, Satori Adventure, said Kobusch had left the base camp and was descending to Namche Bazaar on Wednesday on the way to Kathmandu.
An initial survey showed 3,609 homes had been destroyed in Tibet's Shigatse region, home to 800,000 people, state media reported late on Tuesday, citing local officials. Over 1,800 emergency rescue personnel and 1,600 soldiers had been dispatched to the region.
Footage broadcast on CCTV showed families huddled in rows of blue and green tents quickly erected by soldiers and aid workers in settlements surrounding the epicentre, where hundreds of aftershocks have been recorded.
State media said over 30,000 people affected by the quake had been relocated.
Home to some 60,000 people, Tingri is Tibet's most populous county on China's border with Nepal and is administered from the city of Shigatse, the traditional seat of the Panchen Lama, one of the most important figures in Tibetan Buddhism.
No damage has been reported to Shigatse's Tashilhunpo monastery, state media reported, which was founded in 1447 by the first Dalai Lama.
The 14th and current Dalai Lama, along with Japanese Prime Minister Shigeru Ishiba, Russian President Vladimir Putin and Taiwan President Lai Ching-te, have expressed condolences to the earthquake's victims.
More than 500 aftershocks with magnitudes of up to 4.4 followed the quake, the China Earthquake Networks Centre said.
Over the past five years, there have been 29 earthquakes with magnitudes of 3 or above within 200 km of the epicentre of Tuesday's tremor, according to local earthquake bureau data.
Tuesday's quake was the worst since a 6.2 magnitude earthquake in 2023 that killed at least 149 people in a remote northwestern region.
In 2008, an 8.0 magnitude earthquake hit Sichuan's Chengdu, claiming the lives of at least 70,000 people, the deadliest quake to hit China since the 1976 Tangshan quake that killed at least 242,000 people.