The Israeli military said it was carrying out a raid on Wednesday against Hamas in Al Shifa Hospital, having urged them to surrender with thousands of Palestinian civilians still sheltering inside Gaza Strip's biggest hospital.
Dr. Munir Al-Bursh, director-general of the Gaza health ministry, told Al Jazeera television that Israeli forces had raided the western side of the medical complex.
"There are big explosions and dust entered the areas where we are. We believe an explosion occurred inside the hospital," Bursh said.
Hours later, Gaza health ministry spokesperson Ashraf al-Qidra to Al Jazeera: "The occupation army is now in the basement, and searching the basement. They are inside the complex, shooting and carrying out bombings."
Israeli forces first raided the surgery and emergency departments, Mohammed Zaqout, the Gaza health ministry's director of hospitals, told Al Jazeera.
Reuters was unable to independently confirm the situation at Al Shifa.
Global calls for a humanitarian ceasefire have mounted in recent days, and the fate of Al Shifa has become a focus of international alarm because of worsening conditions in the facility, where thousands of patients, medical staff and displaced people have been trapped during the Israeli assault on Gaza in the past five weeks.
Israel has said that Hamas has a command centre underneath Al Shifa and uses the hospital and tunnels beneath it to conceal military operations and to hold hostages. Hamas denies it.
In a statement, the Israel Defence Forces (IDF) said: "Based on intelligence information and an operational necessity, IDF forces are carrying out a precise and targeted operation against Hamas in a specified area in the Shifa hospital."
The military added: "The IDF forces include medical teams and Arabic speakers, who have undergone specified training to prepare for this complex and sensitive environment, with the intent that no harm is caused to the civilians."
Israeli army spokesman Lieutenant Colonel Peter Lerner told CNN the hospital and compound were for Hamas "a central hub of their operations, perhaps even the beating heart and maybe even a centre of gravity."
The US said on Tuesday that its own intelligence supported Israel's conclusions.
Hamas said on Wednesday that US announcement had effectively given a "green light" for Israel to raid the hospital. The group said it held Israel and US President Joe Biden fully responsible for the operation.