Teams are looking for survivors trapped in the rubble of collapsed buildings.
The quake is the deadliest in the world this year.
Most people who died were in western Iran – in Sarpol-e-Zahab, a town 15km (10 miles) from the border, and other parts of Kermanshah province.
The town’s main hospital was severely damaged, leaving it struggling to treat hundreds of wounded, state TV reported.
A woman and her baby were pulled alive from rubble in the town, Iranian media said.
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