Local authorities put the death toll at 48, but the number is expected to rise as rescuers comb through the rubble.
Japanese rescuers battled the clock and powerful aftershocks on Tuesday as they searched for survivors of a New Year's Day earthquake that killed dozens and caused widespread destruction.
The magnitude 7.5 earthquake that rattled Ishikawa prefecture on the main island of Honshu triggered tsunami waves more than a metre high, caused a major fire and tore apart roads.
On the Noto peninsula, the destruction included buildings damaged by fire, houses flattened, fishing boats sunk or washed ashore, and highways hit by landslides.
"I'm amazed the house is this broken and everyone in my family managed to come out of it unscathed," said Akiko, standing outside her parents' tilting home in the badly hit city of Wajima.
The way 2024 started "will be etched into my memory forever," she said following the "long and violent" earthquake.
"It was such a powerful jolt," Tsugumasa Mihara, 73, said as he queued with hundreds of others for water in the nearby town of Shika.
Local authorities have put the death toll at 48, but the number is expected to rise as rescuers comb the rubble.
"Very extensive damage has been confirmed, including numerous casualties, building collapses and fires," Prime Minister Fumio Kishida said, after a disaster response meeting.
"We have to race against time to search for and rescue victims of the disaster."
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