Gazans combed through the debris of the devastated hospital, collecting the bodies of the dead in the battered enclave Wednesday, hours after a strike killed hundreds sheltering at the facility.

Alongside rows of charred vehicles, volunteers recovered corpses and limbs that were placed in body bags, while the remains of others were covered in white shrouds and blankets.

"This is a massacre," Ahmed Tafesh, who assisted in the recovery effort, told AFP, saying he had collected the eyes, arms, legs and heads of the deceased.

"I have never seen anything like this in my life."

Health authorities in Hamas-ruled Gaza said the explosion killed 471 people at the Ahli Arab Hospital and was caused by an Israeli air strike, one of the thousands it has launched in retaliation for the Islamist group's bloody October 7 attack on communities near the enclave.

Israel has denied responsibility and blamed a faulty militant rocket.

At the nearby Shifa hospital in Gaza City, residents gathered to identify the dead at the hospital's mortuary and take other bodies for burial.

Yahya Karim, 70, was among those searching for clues about the fate of his relatives.

"I don't know how many of them died and how many are still alive," said Karim, admitting that he had planned to shelter in the hospital before the strike.

Outside the Ahli hospital, others who survived the attack who spoke to AFP recounted the terrifying moment when the strike hit.

"We felt there was fire and things were falling on us. We started looking for each other. The electricity cut suddenly, and we couldn't see," said Fatima Saed through tears.

"I don't know how we came out of it."

Gaza resident Adnan al-Naqa told AFP that around 2,000 people were taking refuge at the hospital on Tuesday night at the time of the strike.

"As I entered the hospital, I heard the explosion, I saw a massive fire," said Naqa.

"The entire square was on fire, there were bodies everywhere, children, women and elderly people."

War of words 

With water and food supplies running low, the United Nations estimates that around one million of Gaza's 2.4 million residents are currently displaced, with thousands sheltering in hospitals dotted throughout the densely populated enclave.

As residents surveyed the damage, Israel and Palestinian militants traded blame for the strike.

On Wednesday morning, the Israeli military offered what it said was evidence that Islamist militants were responsible for the blast, saying a review of the strike proved others were at fault.

"The evidence — which we are sharing with you all — confirms that the explosion at the hospital in Gaza was caused by an Islamic Jihad rocket that misfired," military spokesman Daniel Hagari told a press conference in Tel Aviv.

"There was no IDF (Israeli army) fire by land, sea or air that hit the hospital," Hagari said.

US President Joe Biden threw his support behind Israel's account of the strike, telling Prime Minister Benjamin Netanyahu "it appears as though it was done by the other team" after landing in Israel for a high-stakes solidarity visit.

Hamas fired back at the comments from the Israeli military, saying "its outrageous lies do not deceive anyone".

Footage verified by AFP shows a large fire burning at the hospital, while ambulance sirens and some explosions can be heard in the background.

Aerial shots subsequently taken by AFP on Wednesday show the hospital buildings all still standing but damaged, with a small round crater in the courtyard.

A damaged wheelchair, bags and other personal items were left on a patch of grass.

Israel's Arab allies blamed it for the hospital deaths, despite the military's denials.

The United Arab Emirates and Bahrain, which both established ties with Israel in the Abraham Accords of 2020, condemned Israel for the blast.

Morocco, another country that recognised Israel in 2020, also blamed it for the strike, as did Egypt, which became the first Arab country to normalise relations in 1979.

As the two sides pinned blame on each other, Israeli air strikes continued to batter the war-torn enclave, sending residents running for cover early on Wednesday.

For 12 days, Israel has carried out a withering bombardment of the Gaza Strip in retaliation for the killing of 1,400 people who were shot, mutilated or burnt to death in shock cross-border attacks launched by Hamas on October 7.

More than 3,470 people have been killed in Gaza as a result of Israeli air strikes, according to health officials.