Quake struck the Jajarkot district late on Friday night bringing brick houses crumbling to the ground.
At least 69 people have been killed and dozens injured after a strong earthquake hit the west of Nepal.
The shallow quake struck at 11:47pm (18:02 GMT) on Friday around the western area of Jajarkot, a hilly district about 500 kilometres (310 miles) west of the capital, Kathmandu, that is home to about 190,000 people.
The US Geological Survey put the magnitude at 5.6 and said it was just 18 kilometres (11 miles) deep.
The tremors were felt as far away as Kathmandu and even about 600km (375 miles) away in the Indian capital New Delhi.
Jajarkot local official Harish Chandra Sharma said at least 34 people had been killed in his district while in neighbouring Rukum West district, police official Namaraj Bhattarai said at least 35 deaths had been reported.
“Rescue and search teams have to clear roads blocked by dry landslides due to the earthquake to reach the affected areas,” Bhattarai said.
Writing on social media platform X, Nepalese Prime Minister Pushpa Kamal Dahal expressed “his deep sorrow over the human and physical damage caused by the earthquake” and ordered security agencies to launch immediate rescue and relief operations.
Local media footage showed crumbled facades of brick houses, with large pieces of furniture scattered on the ground.
Local officials said it had not yet been possible to establish contact with areas near the epicentre in Ramidanda.
“Houses have collapsed. People rushed out of their homes. I am out in the crowd of terrified residents. We are trying to find details of damages,” police official Santosh Rokka told the Reuters news agency by phone.
At least 20 people were rushed to hospital with injuries, Jajarkot district official Suresh Sunar told Reuters.
“I am out in the open myself. We are collecting details, but due to cold and night, it is difficult to get information from remote areas,” he said.
Nepal lies on a major geological fault line where the Indian tectonic plate pushes up into the Eurasian plate, forming the Himalayas, and earthquakes are a regular occurrence.
In 2015, about 9,000 people were killed in two earthquakes in Nepal. Whole towns, centuries-old temples and other historic sites were reduced to rubble, with more than a million houses destroyed.