The number of dead is counted in Turkey at over 18,000 and in Syria at over 3,300. Bodies lie wrapped in blankets, carpets and tarpaulins on the streets of cities where the morgues are full.
Tens of thousands of people are injured and many have lost their homes.
Aerial images of the quake area show how entire neighborhoods of high-rise buildings have been reduced to twisted metal, pulverized concrete and exposed wires.
Forced to drink his urine
During the night of Friday, early in the morning, a 17-year-old in Gaziantep, Turkey, was rescued to cheers and tears of joy from the boy's relatives.
He had then been trapped in a basement during the racial masses for 94 hours and drank his own urine to survive.
- Thank God you came, said the boy when he was embraced by his mother.
According to experts, it is possible for people to survive in riots for over a week, but the winter cold means that the chances are rapidly diminishing.
Therefore, the rescue work is now increasingly shifting its focus from finding survivors to caring for the injured and demolishing dangerously unstable buildings.
PKK pauses
In the Turkish city of Kahramanmaras, however, the search for survivors has continued, while there are many indications that people under the racial masses have already died.
The winter weather and damaged roads have delayed rescue efforts.
The Turkish government continues to receive criticism for delaying aid in many areas, above all in the hard-hit province of Hatay.
On Friday, the guerrilla movement Kurdistan Workers' Party (PKK), branded a terrorist by the EU and the US, said it was pausing its activities as a result of the disaster "as long as the Turkish state does not attack".
The PKK has been waging an armed rebellion against the Turkish state since 1984.
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Get a summary of the earthquake in Turkey - in 60 seconds.
Photo: TT/AP/EPA