Israeli forces have shot and killed at least 58 Palestinians and left 2,771 injured during mass protests against the opening of the US embassy in Jerusalem, Palestinian health officials say.
The bloodshed marks the deadliest day in the region since the 2014 Gaza war, with Israeli soldiers opening fire on protesters who had to flee for cover.
Palestinians along the Gaza border had earlier hurled firebombs and stones towards troops.
Israel’s military claimed its forces had come under fire during the clashes, adding that some protesters had tried to break through the fence.
It added that troops had shot and killed three Palestinians because they were trying to plant a bomb.
Dr Ashraf Al Qudra, the director of public relations for the Gaza ministry of health, said six children under 18 were among the dead.
He added that 225 children and 79 women were among those injured.
Palestinian president Mahmoud Abbas has condemned what he called Israeli “massacres” in Gaza.
The number killed climbed as the US embassy was opened 45 miles away in Jerusalem, after President Donald Trump recognised the city as Israel’s capital in December 2017.
The relocation of the embassy from Tel Aviv, which was one of Mr Trump’s key campaign promises, infuriated Palestinians who seek East Jerusalem as a future capital.
Israeli Prime Minister Benjamin Netanyahu addressed the crowd at the ceremony and thanked Mr Trump “for having the courage to keep your promises”.
He added: “We are in Jerusalem and we are here to stay.”
In a video message played during the inauguration, Mr Trump said he remains committed to “facilitating a lasting peace agreement” between Israelis and Palestinians.
His daughter Ivanka and her husband Jared Kushner attended the ceremony, as they led a US delegation that included the treasury secretary and four Republican senators.
The White House has said the responsibility for the Gaza deaths “rests squarely with Hamas”, the territory’s ruling organisation which has been designed a terrorist group by the US and EU.
The clashes have raised doubts about Mr Trump’s ambitions to broker what he once said would be the Middle East “deal of the century”.
The Israeli military estimated a turnout of about 40,000 at the Palestinian protest on Monday, saying this fell short of what Hamas had hoped for.
The protests mark the culmination of a campaign led by Hamas to break the blockade of the territory imposed by Israel and Egypt since 2007.
Dozens of Palestinian protesters had already been killed by Israeli army fire in the weeks before the violence on Monday, with the marches having begun in late March 2018.
The timing of Monday’s events was deeply symbolic both to Israel and the Palestinians.
The opening of the US coincided with the 70th anniversary of Israel’s founding.
But it also marks the anniversary of the “nakba”, or catastrophe, when hundreds of thousands of Palestinians fled or were expelled from present-day Israel during the 1948 war.
Israel captured East Jerusalem in the 1967 Middle East war and annexed it in a move not recognised by the international community.
Alistar Burt, the UK’s minister for the Middle East, said: “The violence today in Gaza and the West Bank has been shocking.
“The loss of life and the large number of injured Palestinians is tragic, and it is extremely worrying that the number of those killed continues to rise.
“Such violence is destructive to peace efforts.”
South Africa and Turkey have recalled their ambassadors to Israel and the US for “consultations”.
The Turkish president Recep Tayyip Erdogan said while on a visit to London: “Israel is wreaking state terror. Israel is a terror state.
“What Israel has done is a genocide. I condemn this humanitarian drama, the genocide, from whichever side it comes, Israel or America.”