There are more than 600 injured and the toll is expected to grow as information trickles in from remote mountain villages.
The injured also included children with plastered and bandaged legs and arms.
“The earthquake hit around 2 in the morning. It was too dangerous. We left home (immediately). A lot of people were injured,” said Habibullah from his hospital bed.
Houses were reduced to rubble and bodies swathed in blankets lay on the ground.
The quake struck about 44 km from the city of Khost, near the Pakistani border, the US Geological Survey (USGC) said.
Afghanistan’s Deputy Minister for Disaster Management Mawlawi Sharafuddin said the government will be giving out 100 000 AFN ($1,116.19) cash to victims’ families and 50 000 AFN ($558.10) to the families of injured people.
Mounting a rescue operation will prove a major test for the Taliban, who took over the country last August and have been cut off from much international assistance because of sanctions.
Tremors were felt by about 119 million people in Pakistan, Afghanistan, and India, the EMSC said on Twitter, but there were no immediate reports of damage or casualties in Pakistan.
The EMSC put the earthquake’s magnitude at 6.1, though the USGC said it was 5.9.
Large parts of South Asia are seismically active because a tectonic plate known as the Indian plate is pushing north into the Eurasian plate.