In the worst mass killing in Japan since at least World War II, a murderous rampage by a knife-wielding attacker intent on eliminating handicapped people has resulted in 19 deaths and left more than 20 other people injured, according to Japanese news outlets.

The rampage took place early Tuesday morning at Tsukui Yamayuri-en, a garden facility for elderly and handicapped people in the town of Sagamihara, according to the English-language service of NHK, Japan’s leading public broadcast network.

An official with the Kanagawa prefecture identified the suspect as Satoshi Uematsu and told a news conference Tuesday that Mr. Uematsu had broken into the building about 2:10 a.m. by breaking a first-floor glass window at the facility.

Mr. Uematsu was described as a 26-year-old man who had worked at the hospital before, and reportedly told police that he committed the murders from a pro-euthanasia conviction.

“I want to get rid of the disabled from this world,” he told police, according to Asahi Shimbun, the country’s second-largest newspaper.

The NTV broadcast network said Mr. Uematsu was angry at having been fired in February.

Sagamihara fire officials said 19 fatalities had been confirmed by doctors at the site and 26 more people were wounded in the rampage.

Mr. Uematsu was able to escape the facility but turned himself in to police about an hour later, saying “I did it,” according to Japanese news outlets. He had a bloody knife and blood-stained cloth, according to Japanese authorities.

A neighbor told NHK that she saw police cars arrive around 3:30 a.m.

“I was told by a policeman to stay inside my house, as it could be dangerous,” she said. “Then ambulances began arriving, and blood-covered people were taken away.”

The facility, about 30 miles west of Tokyo in the neighboring prefecture, had about 160 residents at the time of the attack, according to local officials.

Mass stabbings are commoner in Japan than the U.S., because Japan’s strict gun control laws force murderers to use other weapons.

An ex-janitor stabbed eight children to death at an Osaka elementary school in 2001, and a truck driver’s 2008 rampage in Tokyo’s Akihabara gambling district resulted in seven deaths.

The most famous mass murder in Japanese history was probably the 1998 poisoning of the Tokyo subway by the doomsday cult Aum Shinri Kyo, which killed 13 people and sickened more than 5,000.

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