Locals have described their fear and confusion as the powerful quake hit in the early hours of the morning.
"Paintings fell off the walls in the house," Samer, a resident of Syrian capital Damascus told Reuters.
"I woke up terrified. Now we're all dressed and standing at the door."
In the Turkish city of Gaziantep, Erdem described feeling shaken around "like a baby in a crib".
"I have never felt anything like it in the 40 years I've lived," he told Reuters over the phone.
"Everybody is sitting in their cars, or trying to drive to open spaces away from buildings."
"I imagine not a single person in Gaziantep is in their homes now."
Another man in Pazarcık said his family had woken to powerful shocks, and faced a cold and tense wait for sunrise to survey the damage.
"There are destroyed buildings around me, there are houses on fire. There are buildings that are cracking. A building collapsed just 200 meters away from where I am now," Nihat Altundağ said, in a report by The Guardian.
“People are all outside, all in fear.”