Israeli forces left Al Shifa Hospital in Gaza City on Monday after a two-week operation by special forces who detained hundreds of suspected Palestinian militants and left a wasteland of destroyed buildings.
With access to Gaza's biggest hospital severely restricted, the Israeli and Palestinian versions differed sharply.
Palestinian officials called the raid on a hospital treating severely wounded patients a war crime, while Israeli officials said special forces units conducted a targeted strike against a Hamas stronghold deliberately located among vulnerable civilians.
Thousands of Palestinians - 6,200 according to the Israeli military - had been sheltering in the complex, one of few locations in the north of Gaza with some access to electricity and water.
Ismail Al-Thawabta, director of the Hamas-run Gaza media office, said Israeli forces had killed 400 Palestinians in and around the hospital including a woman doctor and her son, also a doctor, and put the facility out of action.
"They bulldozed the courtyards, burying dozens of bodies of martyrs in the rubble, turning the place into a mass graveyard," he said. "This is a crime against humanity."
Hamas and medics deny any armed presence in hospitals but Israeli military spokesperson Daniel Hagari said the site had been turned into a major operating center by the Palestinian armed groups Hamas and Islamic Jihad.
He said emergency patients had been evacuated from the hospital before the operation and said no Palestinian civilians, patients or medical personnel had been harmed by Israeli forces.
He said three of the main buildings in the complex had been destroyed in the fighting - the main emergency room, the maternity ward and an annex known as the Qatari Building - after Hamas fighters refused calls to surrender.
"They're using those places, they know it's a safe haven, they know that they use it intentionally as their command and control center," he told reporters on Monday.
He said 200 militants and two Israeli servicemen had been killed during the operation and more than 900 suspected militants detained, of whom some 500 were identified as Hamas or Islamic Jihad, including senior commanders and officials.
He said documents recovered by Israeli forces showed the hospital was used as a base to control the northern section of the Gaza Strip, which has largely been destroyed since the start of the ground invasion in October.
As well as weapons and computers equipment, cash worth more than $3 million was also recovered, he said.
"It was a significant operation in terms of the blow that Hamas and Islamic Jihad suffered," Hagari said.
'The place is destroyed'
Hamas said Israel detained 350 people from inside Shifa, including patients and displaced people and dozens of others from districts nearby.
Footage on social media, unverified by Reuters, showed corpses, some covered in dirty blankets, scattered around the charred hulk of the hospital, many of whose outer walls were missing. It showed ground heavily ploughed up, and numerous buildings outside the facility flattened or burned down.
"I haven't stopped crying since I arrived here, horrible massacres were committed by the occupation here," said Samir Basel, 43, speaking to Reuters via a chat app as he toured Al Shifa.
"The place is destroyed, buildings have been burnt and destroyed. This place needs to be rebuilt - there is no Shifa hospital anymore."
One video obtained by Reuters showed some Palestinians returning to the area to retrieve mattresses and other belongings from under rubble where they had previously been sheltering.
"We evacuated hoping to come back and find my belongings. I have nothing left. My house was bombed and everything has gone. I have nothing left," one woman told Reuters.
"I sought shelter at schools but they told me there was no space for me. Where do I go?"
It was the second major Israeli incursion into Al Shifa Hospital after an earlier operation in November.
Israel's military has also stepped up preparations for an assault on Rafah, the southern city where more than 1 million people displaced by the fighting have been sheltering, many in improvised encampments.
In Rafah, an Israeli airstrike killed six people, Palestinian health officials said.
More than 32,000 Palestinians have been killed, including 63 in the past 24 hours, in Israel's military offensive in Gaza, according to the Palestinian health authorities.
In the Oct. 7 attack, Hamas killed 1,200 people and took 253 hostages, according to Israeli tallies. The military has published the names of 257 soldiers killed in Gaza combat.
Meanwhile, in Egypt, mediators held talks with Israeli officials in a bid to bridge gaps between the positions of Hamas and Israel over reaching a ceasefire.
But a Palestinian official close to the mediation effort told Reuters: "There has been no sign of a breakthrough."