The 6.4 magnitude quake struck offshore in the early hours of the morning, with 100 people confirmed dead.
The death toll continues to climb and nearly 300 people are said to be injured - more than 70 of them seriously.
Rescuers are using earth-movers and bare hands to search for survivors after an earthquake hit Aceh province on Wednesday morning.
The head of Indonesia's national disaster and relief command centre, Bambang Sulistyo, says hundreds of personnel have already been deployed.
"Now, we're trying to search for survivors trapped underneath the debris, pull them out, evacuate them as soon as possible and transfer them to a safe place."
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More than 100 homes, just as many shops, and over a dozen mosques have been destroyed.
National Disaster Management Agency spokesperson Sutopo Nugroho says the number of casualties is expected to rise.
"We estimate the number of casualties will continue to rise as some of the residents are still likely under the rubble of the buildings. The search and rescue operation is still underway."
Pidie Jaya and Pidie, with a population of about 140,000, are the worst-affected districts.
Indonesian President Joko Widodo has ordered immediate assistance be sent to the region, which sits on the northern tip of Sumatra island.
Thousands of people have been forced to take refuge in mosques and temporary shelters - some separated from family members.
Earthquake victim Sulaiman says he doesn't know whether his children are safe.
"I have no idea, some of them were not at home, they stayed at the boarding school."
Australia's Foreign Minister, Julie Bishop, says no Australians are believed to be among the victims.
"I have contacted our ambassador in Jakarta, and I urge all Australians to abide by the directions of local authorities. If anyone has concerns about family or friends in Aceh, they should seek to contact them. Otherwise, contact the Australian government's 24-hour consulate helpline on 1 300 555 135."
At least five aftershocks were felt in the hours following the earthquake.
In 2004, more than 160,000 people were killed when a tsunami hit the region.
