At least one person has died, and several are trapped under rubble after a 4.0 magnitude earthquake struck off the coast of Naples.
Around 25 people are said to have been injured as they ran out onto the streets when the quake hit the Italian resort of Ischia just before 9pm on Monday evening.
Several buildings – including a church – collapsed, killing one woman and trapping half a dozen people, including three children.
Most trapped residents were responding to rescue crews and were expected to be pulled out alive, according to police.
However, the death toll is expected to rise.
Civil protection crews – who were already present on the island to fight the recent forest fires – are now examining buildings to assess damage.
One local man said the tremor felt like a “bomb explosion”, and all electricity was knocked out.
Another witness wrote on Twitter: “A horrible experience, everything was shaking, plunged into darkness, houses were collapsing… a nightmare.”
The island is crowded with tourists at this time of the year, at the height of the summer season.
There have been at least 14 aftershocks following the quake, leading many worried residents to spend the night out in the open.
The quake comes just two days before the one-year anniversary of a powerful 6.2-magnitude earthquake that devastated several towns in central Italy, killing nearly 300 people.
Italy sits on the boundary between the Eurasian and African tectonic plates, making it vulnerable to seismic activity whenever the large plates collide.