There are fears the number will continue to rise.
Authorities are still trying to work out just how many people were living or staying in the historic towns flattened by the 6.2 magnitude quake.
As rescue workers sift through the rubble that was the town of Amatrice [ah-mah-TREE-cheh], a 4.3 magnitude aftershock sparks more panic, confusion and terror.
But in the nearby village of Cascello, virtually destroyed by the earthquake this week, there's an eerie silence on the deserted streets, only punctuated by the sound of a running tap.
Alessandra Cioni crawled out of her house, which collapsed during the quake.
The 45 year-old has lost everything but considers herself one of the lucky ones.
"The fact that we have survived means we have to move forward one minute at a time. Tomorrow does not exist, we can't think about tomorrow, a minute at a time. Thank God I have a little of everything, something to eat. We have been saved, not like half of this place which has lost lives. I don't say we are celebrating, as we feel alone, we miss our friends and relatives."
Despite the threat posed by aftershocks, workers continue digging.
There's been the occasional miracle story of survival but mostly theirs has been the grim task of carefully retrieving bodies.
Fire Department spokesman Luca Cari and his team are vowing to press on.
"We need to know firstly the exact number of people who are missing before we can say what work is waiting for us. We will obviously move forward without interruption until we are sure there is no one left."
Albanian nun Sister Marjana Lleshi had lost hope of rescue, trapped in her room in a home for the elderly where she worked.
The 35 year-old hid under her bed to escape the falling debris and started messaging friends to say goodbye and ask them to pray for her.
"I couldn't send a message like this to my family because I was afraid that my father would have en emotional collapse and die hearing something like that. Losing all hope of being saved, I knew I was going to die but I couldn't tell my family 'I am dying.'"
As the search continues, the size of the job is still being assessed.
In the summer, the populations of these popular tourist towns can swell ten-fold.
Fire department official Lorenzo Botti says locating any survivors in buildings reduced to piles of debris is challenging.
"We are still using sniffer dog units as the starting point in the search and rescue operations and we are putting everything we have out in the field in order to continue the search operations. All the information is shared and communicated between the different teams."
He's still hoping to find as many people as possible alive, despite the odds.
