
Photographs taken before and after the devastating earthquake in Italy this morning show how small towns and villages have been left in ruins.

Where once there were cobbled courtyards and terracotta-coloured buildings, now there are only piles of rubble and twisted metal.

Emergency service crews can be seen in some of the 'after' pictures as they rushed to rescue survivors from the debris.

One 'before' picture taken in Amatrice shows the town's elegant clock tower, which has almost survived intact, but some of the houses nearby have disintegrated.

The square in the town features cobbled pavement, hanging flower baskets and a peach-coloured traditional building, but it's now utterly devastated.

The photographs show how some buildings in the towns suffered more than others. In one street in Arquata del Tronto, one building completely collapsed while the building next door only suffered damage to the facade.

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‹ Slide me › A clock building was once a key feature in the town of Amatrice it is now one of the only remaining structures in a once idyllic street

‹ Slide me › The neatly stacked pile of tires outside a garage in Accumoli are now scattered across the road, while emergency services crews rushed to rescue trapped residents

‹ Slide me › A once quiet and picturesque street is seen with locals going about their daily lives before the earthquake. On Wednesday the beautiful balcony of the building collapsed into a pile of rubble

‹ Slide me › A town square in Amatrice featuring cobbled pavement, hanging flower baskets and a peach coloured traditional Italian building is now utterly devastated and left in ruins

‹ Slide me › The same town square in Amatrice is seen here from a different angle. Before the building is intact but after half of it has crumbled to the ground

‹ Slide me › A once delightful Italian street in Amatrice filled with terracotta-coloured buildings now appears as a mass of grey rubble

‹ Slide me › The shock waves of the earthquake last night tore through this large building in Accumoli, leaving a gaping space where most of the structure once stood

‹ Slide me › The photographs show how some buildings in the towns suffered more than others. In this street in Arquata del Tronto, one building completely collapsed while the building next door only suffered damage to the facade

‹ Slide me › Emergency services initially struggled to reach all the affected areas because they are mostly small towns and villages spread out across the mountainous area. This building in Arquata del Tronto now has a gaping hole in one wall

Strong tremors were felt in the capital Rome, more than 100 miles from the epicenter near the city of Perugia - the epicentre was between Norcia and Accumoli

The powerful earthquake killed at least 38 people including two children, with many buried as they slept.

The 6.2-magnitude quake at around 3.30am local time was so powerful it rocked buildings in the centre of Rome more than 100 miles away and was felt across Italy.

Survivors have described 'apocalyptic' scenes in towns and villages near the city of Perugia - the capital of the tourist-packed Umbrian region, which is especially popular with British holidaymakers.

Swathed in blankets, a heavily wounded man gazes at his destroyed hometown of Amatrice which has been cut off from the world after its roads were buried in rubble

At least ten people have been killed after a 6.2-magnitude earthquake rocked central Italy (pictured, rescuers carry a man from the rubble in the town of Amatrice)

Shocking: A survivor in Amatrice is helped to safety after a powerful earthquake has rocked Italy overnight killing at least 38 people and burying many more as they slept

Collapsed: An unconscious survivor on a makeshift stretcher is carried from the what remains of a collapsed building in Amatrice

Aftermath: Residents of Amatrice in central Italy has been left in ruins overnight in an earthquake that shook areas up to 100 miles away, including Rome

At least 38 are feared dead in the earthquake after people were crushed by falling buildings or suffocated by the rubble - rescuers have pulled out several from the ruins but can still hear voices from below.

Its epicentre was in Norcia in Umbria, about 105 miles north east of Rome, while the hardest-hit towns were reported as Amatrice, Accumoli and Pescara del Tronto. Falling bridges and landslides mean some areas are still cut off with emergency teams can only get there on foot.

The mayor of Accumoli, Stefano Petrucci, said this morning: 'My town isn't here anymore' as people were carried out of ruined buildings on stretchers and people desperately searched the debris for survivors or sobbed as they inspected their own ruined homes.

Photographer Emiliano Grillotti said that in Accumoli he saw over 15 people digging with their bare hands to save a family of four with two children, according to Repubblica. He said: 'I can hear one of the children screaming'.

The first victims of the devastating quake were an elderly couple whose home collapsed in Pescara del Tronto, in the Marche region, around ten miles from the epicentre. A family of four, including a eight-month-old baby and his brother, nine, were also reported dead in the town of Accumoli.

Huddled: A shocked woman and man are seen wrapped in blankets in front of collapsed houses in Amatrice, central Italy

Bloodied: An injured nun checks her mobile phone as she lies near a ladder and a blanket following an earthquake in Amatrice

Agony: A man is pulled out of the rubble with a large gash in his head following the earthquake in Amatrice

Survivor: A dust-covered man trapped in the rubble of his home as he slept is pulled from a hole by rescuers in Amatrice this morning

Two brothers, aged four and seven, were pulled from the rubble nearby after hiding under a bed with their grandmother as the building fell down. Some 100 people were still unaccounted for in the village of Arquata del Tronto.

A newborn baby was also found dead after being pulled from a family home in the center of Arquata del Tronto.

The quake hit during the summer when the populations of the towns and villages in the area, normally low during the rest of the year, are swelled by holidaymakers.

One person has died and a family of four including two young children, aged 8 months and 9 years, are feared dead in their collapsed house in Accumoli, according to its mayor.

Stefano Petrucci said: 'Now that daylight has come, we see that the situation is even more dreadful than we feared, with buildings collapsed, people trapped under the rubble and no sound of life.

'We have a tragedy here. Four people are under the rubble, but they are not showing any sign of life. Two parents and two children.

'It is a disaster, we have no light, no telephones, the rescue services have not got here yet.'

The quake also destroyed homes and buried people under rubble in the small town of Amatrice, where many more are feared dead.

Debris: This is an overhead view of Amatrice, whose historic centre has been wiped out by the powerful earthquake overnight

An aerial photograph from the Italian Fire Brigade shows the collapsed and damaged houses in Amatrice

A video has emerged of a young girl covered in dust being carried to safety after she was pulled from the rubble in Amatrice

'The roads in and out of town are cut off. Half the town is gone,' said the town's mayor Sergio Pirozzi.

He added: 'There are people under the rubble... There's been a landslide and a bridge might collapse. The situation is dramatic, there are many dead. I cannot give a toll for now because rescue efforts are under way and it is very, very difficult'.

The centre of Amatrice was devastated, with entire palazzos razed to the ground. Rocks and metal tumbled on to the streets and dazed residents huddled in piazzas as aftershocks continued into the early hours.

'The whole ceiling fell but did not hit me,' marveled resident Maria Gianni. 'I just managed to put a pillow on my head and I wasn't hit luckily, just slightly injured my leg.'

Another resident said she had been woken by the shaking in time to witness the wall of her bedroom cracking open. She was able to escape into the street with her children.

Nothing left: This shop's sign is hanging off and its walls are collapsed after the quake shook the area at around 3.30am

Tragic: Rescue workers and police officers carry a victim out of the rubble inside a blanket in the village Amatrice

Search: A sniffer dog is used to seek out any survivors under a collapsed building in Amatrice on Wednesday morning

Reaction: A dust-covered man cries with his head in his hands as the shock of what has happened overnight sinks in

Ruins: A lamppost is seen leaning dramatically to one side next to a devastated building and rescue workers

Missing: The side of a traditional beige building is collapsed into grey rubble in the town of Amatrice

One witness named Marco, a sanitation worker from Amatrice, told Repubblica how everything 'fell apart' in an instant.

'It was a miracle for me to survive... I just woke up when suddenly everything collapsed. Ten second were enough to destroy everything,' he said.

A witness in Configno, near Amatrice, recalled: 'It was a nightmare. We woke up at 3.35am, the furniture falling down, walls moving more than a meter. We rushed out, many are still in their underpants here, in the street. We did some bonfires in the square and went to help old people to get out from their houses.'

As daylight dawned, residents, civil protection workers and even priests began digging out with shovels, bulldozers and their bare hands, trying to reach survivors. There was a sigh of relief as a woman was pulled out alive from one building, followed by a dog.

'We need chain saws, shears to cut iron bars, and jacks to remove beams: everything, we need everything,' civil protection worker Andrea Gentili told The Associated Press.

'I don't know what to say. We are living this immense tragedy,' said the Rev. Savino D'Amelio, an Amatrice parish priest. 'We are only hoping there will be the least number of victims possible and that we all have the courage to move on.'

In Amatrice, the ANSA news agency reported two bodies had been pulled from one building. The Rev. Fabio Gammarota told ANSA another three were killed in a separate collapse.

Residents and photographers stand next to damaged buildings after the strong heartquake hit Amatrice

A man covered in a blanket walks in front of the rubble appears to walk in children's shoes after escaping the earthquake

Search and rescue teams survey the rubble in Amatrice as a man walks over it with his phone in hand

A mother embraces her terrified son in a blanket in Amatrice as they stand alongside other locals in the town

Amatrice Mayor Pirozzi told state-run RAI radio and Sky TG24 that residents were buried under collapsed buildings, that the lights had gone out and that heavy equipment was needed to clear streets clogged with debris.

Aleandro Petrucci, the mayor of nearby Arquata del Tronto, said Pescara was one of 'two or three hamlets that have just completely disintegrated.'

A resident of the village told Rai that she had been woken by the shaking in time to witness the wall of her bedroom cracking open. She was able to escape into the street with her children.

A family friend of a tourist from Toronto, Canada, who was caught up in the earthquake told MailOnline how he escaped.

Silvano Rendina was awoken and 'climbed through the window of his father's ancestral home in Pescara del Tronto when the earthquake struck'. After helping numerous townsfolk escape the rubble and after daybreak, he took photos of the utterly devastated town.

Mr Rendina eventually made it to a bar in neighbouring Tresungo, which had WiFi and bottled water for rescuers coming from Pescara del Tronto.

'He said he thought they had got out all those who were verbally responsive, but reported that there were at least three other deaths other than the elderly couple reported. He said there had to be many more trapped,' family friend Mary Pat Elliott told MailOnline.

Two bodies were recovered from rubble in Amatrice, a mountain village in neighbouring Lazio that was packed with visitors at the peak of the summer season.

Paola Mancini, 79, told local newspaper Corriere the first words she heard were ‘run, run, everyone outside.’

She was in the hospital Grifoni, in Amatrice, when the earthquake started. A nurse screamed for everyone to get out into the street.

She said: ‘There were two of us in the emergency room. We got up and ran as quickly as possible. We were in the hall, where we found a doctor who calmed us as much as he could.'

She was admitted into the hospital on Tuesday. This morning she was in the street along with the rest of the 14 inhabitants of the hospital.

Many buildings in center of Amatrice were razed by the 6.1 magnitude quake, which struck at around 3.30am (local time)

'There are people under the rubble... There's been a landslide and a bridge might collapse,' said the mayor of Amatrice (pictured)

The mayor of quake-devastated Amatrice (pictured) says rescue teams are trying to reach all 69 hamlets around his central Italian city and that so far 17 deaths have been confirmed in Amatrice alone

Ryan Sloan, a lawyer based in Glasgow, described the moment the earthquake woke him in Rome as the 'most terrifying moment' of his life.

He said: 'Woke up as felt like someone violently rocking bed.'

Sarah Conrad, who works for YouTube in London and is visiting the Italian capital, said she was woken up in the early hours and also felt aftershocks.

She tweeted: 'Pretty sure I was just woken up by an earthquake in Rome.

'I thought someone snuck into my hotel room and was jumping on the bed. Both scary!'

Paul O' Halloran, whose Twitter profile said he was in Rome, said: 'Just got woke up by an earthquake! Bed and window shutters moving!'

Toby Shaw, from Hampshire, tweeted: 'I'm really hoping that I've just experienced an earthquake in Rome, otherwise I'm not sure I want to know what it was that shook the room.'