A powerful earthquake rattled a remote area of central Italy on Wednesday, leaving at least 120 people dead and scenes of carnage in mountain villages.

A powerful earthquake rattled a remote area of central Italy on Wednesday, leaving at least 120 people dead and scenes of carnage in mountain villages.

With 368 people injured and an unknown number trapped under rubble, the figure of dead and wounded was expected to rise in the wake of the pre-dawn quake, Prime Minister Matteo Renzi warned.

"This is not a final toll," he said.

Hundreds of people were to spend a chilly night in hastily-assembled tents with the risk of aftershocks making it far too risky for them to return home.

Scores of buildings were reduced to dusty piles of masonry in communities close to the epicentre of the quake, which had a magnitude of between 6.0 and 6.2.

It hit a remote area straddling Umbria, Marche and Lazio at a time of year when second home owners and other visitors swell the numbers staying there. Many of the victims were from Rome.

The devastated area is just north of L'Aquila, the city where some 300 people died in another quake in 2009.

More than half of the deaths occurred in and around the villages of Amatrice, Accumoli and Arquata del Tronto.

Guido Bordo, 69, lost his sister and her husband after they were trapped inside their holiday house in the hamlet of Illica, near Accumoli.