In Pictures | Medieval basilica among ancient buildings destroyed by Italy's 6.6 magnitude quake
This was the strongest tremor that hit Italy in 36 years.
On Sunday, a third powerful earthquake hit Italy four days after quakes of 5.5 and 6.1 magnitude hit the same area and nine weeks after nearly 300 people died in an August 24 quake that devastated the tourist town of Amatrice at the peak of the holiday season.
The quake struck another painful blow to the rich artistic heritage of villages that dot the Apennine Mountains. The worst damage was reported in Norcia, a town in Umbria closest to the epicenter.
Italy's most powerful earthquake in 36 years dealt a new blow on Sunday to the country's seismically vulnerable heart, sending terrified residents fleeing for the third time in nine weeks and flattening a revered six-century-old church.
The earthquake which hit Italy in two months spared human life but struck at the nation's identity, destroying a Benedictine cathedral, a medieval tower and other beloved landmarks that had survived the earlier jolts across a mountainous region of small historic towns.
Italian Premier Matteo Renzi said the nation's "soul is disturbed" by the series of quakes.
Here are some of the photographs of devastation and an attempt at recovery.
(With agency inputs)
Also read: Powerful 6.6 magnitude quake hits Italian town Norcia