The Israeli army's raid of Gaza's Al-Shifa Hospital entered a fourth day on Thursday, amid reports buildings inside the medical compound have been destroyed and people sheltering inside were ordered to leave, including hundreds of patients.
Almost one hundred Palestinians were killed at the hospital in the early hours of Monday.
Israel has claimed to have killed more than 50 "terrorists" over the past day and "eliminated over 140" inside the hospital complex since the start of the assault.
Palestinian health authorities and international NGOs have strongly denied claims by Israel that Hamas fighters are based in the hospital.
It is still unclear how many patients and other civilians have been killed in the raid.
Israel blew up a building for specialist care at Al-Shifa and ordered an evacuation of the entire hospital, according to Al Jazeera.
Al-Shifa, the Gaza Strip's biggest hospital, is now one of the few partially operational healthcare facilities in the north of the territory, which comes amid a devastating health and hunger crisis.
It has also been housing displaced civilians, who have fled or been expelled from their homes in Israeli assaults elsewhere in Gaza.
Witnesses also reported air strikes on the devastated neighbourhood where the hospital is located.
The health ministry in the besieged territory said it had received calls from people near the hospital site who claimed there were dozens of casualties.
Israeli forces also conducted widespread arrests including of doctors and patients, as well as beating and detaining Al Jazeera journalist Ismail al-Ghoul, who was released 12 hours later.
According to the Gaza health ministry, approximately 30,000 people, including displaced civilians, wounded patients and medical staff, are trapped inside.
Ismail Al-Thawabta, director of Gaza's government media office, said all of those killed had been wounded patients and displaced persons inside the hospital.
"The Israeli occupation army practices lying and deception in spreading its narrative as part of justifying its continuous and law-breaking crimes, which violate international law, international humanitarian law," he said.
Senior Palestinian police officer General Fayeq al-Mabhouh, the head of police operations in Gaza, was also killed in the raid.
On Wednesday, Israel's military claimed it had killed around 90 "gunmen" and arrested 160 "suspects" - an allegation Hamas has denied.
"Over the past day, the troops have eliminated terrorists and located weapons in the hospital area while preventing harm to civilians, patients, medical teams, and medical equipment," the military said in a statement.
It also published the names and photographs of two Israeli soldiers killed in the operation.
Israel has long claimed that Hamas fighters are using the hospital as a "command centre", however has never substantiated the allegation. It has repeatedly attacked the hospital, patients and medical workers.
Israel faced backlash when troops first raided Al-Shifa hospital last November, ceasing the hospital's operations, resulting in the deaths of at least 40 patients, including four premature babies, according to the United Nations.
The Israeli military previously posted a video showing "evidence" of Hamas activity at the hospital but this was soon deleted after experts pointed out inaccuracies. It later republished a near-identical video with some alterations – questioning the validity of Israel's claims.
Medical Aid for Palestinians (MAP) have said the repeated Israeli raids on Al-Shifa and other hospitals is having a huge impact on healthcare in Gaza.
"Israeli forces have raided Al Shifa Hospital four times since October. We have been saying since then that there can be no justification for forcing the closure of Shifa Hospital, with the devastating impact on civilian lives that this will bring," the health charity told The New Arab.
"As an occupying power, it is Israel's duty to ensure the proper functioning of Palestinian health facilities and the protection of medical personnel, the sick and the wounded. Instead, Israel's attacks and siege have forced the near-total collapse of Gaza's health system," MAP added.
While the White House publicly backed Israel's claim that Al-Shifa is being used by Hamas in November, US senator Chris Van Hollen told The Washington Post there were "important and subtle differences" between what the Biden administration was saying and what intelligence showed.
After the raid in December, The Washington Post published a report finding that "the evidence presented by the Israeli government falls short of showing that Hamas had been using the hospital as a command-and-control centre".
"What happens in Al-Shifa Hospital is a war crime and is part of the war of genocide conducted by the Israeli occupation," said senior Hamas official Basem Naim, who has previously served as a health minister.