The 6.2 magnitude quake could be felt in Rome, almost 200km away, reported the New York Times.
"Half the town is gone. There are people under the rubble... There's been a landslide and a bridge might collapse."
Authorities also said at least two people were killed in Pescara del Tronto, in the Ascoli Piceno province.
Mayor of Arquata Aleandro Petrucci says "all the houses have collapsed" in Pescara del Tronto, the Telegraph reports.
"It's a disaster. We are trying to evacuate the village and move them to a sports field. I've just arrived and I feel like crying. I've never seen such an apocalyptic scene except for the L'Aquila earthquake on television."
The quake's path of destruction has led to other places as well, like the Tyrrheniaanse coast and Sperlonga, a popular resort town in Lazio.
Italian officials said that at this stage it is still difficult to determine how many people were killed and how much damage there is.
The National Institute of Geophysics and Vulcanology told The New York Times in the two hours following the quake, there were more than a dozen earthquakes in the affected area, but none were as powerful as the first one.
Sources: Daily Mail, The New York Times, The Telegraph