Rescue crews dug through piles of splintered houses and crushed cars in a search for victims of a half-mile-wide tornado that killed at least 116 people as it blasted a Missouri town off the map and tore through its hospital.
It was the deadliest single twister in the US in nearly 60 years and the second major tornado disaster in less than a month.
Authorities fear the toll could rise as the full scope of the destruction in Joplin emerges: house after house reduced to slabs, cars crushed like cans, and shaken residents roaming streets in search of missing family members.
The danger was by no means over with fires from gas leaks burning across town, and more violent weather loomed, including the threat of hail, high winds and even more tornadoes.
At daybreak, the city’s south side emerged from darkness as a barren, smoky wasteland.
“I’ve never seen such devastation − just block upon block upon block of homes just completely gone,” said former state legislator Gary Burton who was helping at a volunteer centre at Missouri Southern State University.
Unlike the multiple storms that killed more than 300 people last month across the South, Joplin was smashed by just one exceptionally powerful tornado.
Not since a June 1953 tornado in Flint, Michigan, had a single twister been so deadly. That storm also killed 116, according to the National Weather Service.
Authorities were prepared to find more bodies in the rubble throughout the gritty, working-class town of 50,000 people about 160 miles south of Kansas City.
Missouri governor Jay Nixon said he did not want to guess how high the death toll would eventually climb, but he said: “Clearly, it’s on its way up.”
Seventeen people were pulled alive from the rubble. An unknown number of people were hurt.
Some of the most startling damage was at St John’s Regional Medical Centre, where staff had only moments to bustle their patients into the hallway. Six people died there, five of them patients, plus one visitor.
The storm blew out hundreds of windows and caused damage so extensive that doctors had to abandon the hospital soon after the twister passed.
A crumpled helicopter lay on its side in the car park near a single twisted mass of metal that used to be cars.