Israel said its forced entered Gaza's largest hospital - where thousands of patients including newborns are stranded with no electricity - early on Wednesday in the hunt for Hamas militants.
The Israeli army has extended its control across Gaza City and the north of the enclave, as Israel accuses Hamas of using Palestinians as human shields by positioning a massive compound inside and underneath the hospital building. Hamas has denied this.
Mohammed Zaqout, the director of hospitals in Gaza, said Israeli tanks had entered the medical compound and that soldiers had entered buildings including the emergency and surgery departments, which house intensive care units.
"The occupation forces stormed the buildings," he told AP. He said the patients, including children, are terrified.
"They are screaming. It's a very terrifying situation ... we can do nothing for the patients but pray."
The Israeli military said it was carrying out a "precise and targeted operation against Hamas in a specified area in the Shifa Hospital." It said it warned "relevant authorities in Gaza" that all military activities within the hospital must cease.
"Unfortunately, it did not."
The Israeli military said that its forces raiding Shifa have medical teams and are searching for hostages as part of the operation.
On Wednesday morning the Israel Defense Forces said incubators, baby food and medical supplies it provided have reached the hospital.
Israeli forces also claimed control of several key buildings and a downtown neighborhood in Gaza City.
Israel says Hamas has a massive command centre inside and beneath the hospital, but has not provided visual evidence, while Hamas and the hospital staff have repeatedly denied the allegations.
Hours before the raid, the US said its own intelligence suggests Hamas used Shifa and other hospitals, and tunnels beneath them, to support military operations and hold hostages.
Most people living in Gaza City and surrounding areas have fled after weeks of Israeli bombardments. Hardly any aid has been delivered to the the north, which has been without power or running water for weeks.
It comes after Hamas killed some 1,200 people and seized around 240 captives in a surprise October 7 attack into southern Israel.
The UN agency for Palestinian refugees said on Tuesday that its fuel depot in Gaza was empty and that it would soon cease relief operations, including bringing limited supplies of food and medicine in from Egypt for the more than 600,000 people sheltering in severely overcrowded UN-run schools and other facilities in the south.
On Wednesday Israeli forces allowed some 24,000 liters of fuel in for humanitarian efforts, officials said.
Thousands of displaced people who had been sheltering at Shifa, along with patients who were able to move, had fled the medical compound in Gaza City through a corridor established by Israeli forces in recent days as Israeli troops encircled the complex and battled Hamas militants outside its gates.
The hospital had stopped operations over the weekend amid a lack of electricity and supplies.
The Health Ministry said 40 patients, including three babies, have died since Shifa's emergency generator ran out of fuel Saturday. Another 36 babies are at risk of dying because there is no power for incubators, according to the ministry.
Israeli troops have extended their control across northern Gaza, capturing the territory's legislature building and police headquarters.
Israeli military spokesman Daniel Hagari said Israeli forces have completed the takeover of Shati refugee camp and are moving about freely in the city as a whole.
In a nationally televised news conference, Defense Minister Yoav Gallant said Hamas had "lost control" of northern Gaza and that Israel made significant gains in Gaza City.
