Destroyed buildings, crushed vehicles and debris could be seen in cities such as Machala and Cuenca in Ecuador, as rescue officials rushed to lend aid and panicked residents ran into the streets.
The quake, which the United States Geological Survey (USGS) put at a magnitude of 6.8 and a depth of nearly 41 miles (66 kilometers), struck at 12:12 local time (1712 GMT).
Its epicenter was in the Ecuadoran municipality of Balao, near the border with Peru, authorities said.
"I went out into the street because I saw people starting to run in panic, getting out of their cars," Magaly Escandon, a sewing supplies saleswoman in Cuenca, told AFP.
Ecuador's presidency reported 13 dead -- 11 in the province of El Oro and two in the province of Azuay.
In the Peruvian city of Tumbes on the border with Ecuador, a four-year-old girl died after a brick hit her on the head, according to an official report.
"There where the pool of blood is, I was playing with my... niece and a brick fell on her," her uncle David Alvarado told AFP.
The tremor was also strongly felt in other cities including Guayaquil, Quito, Manabi and Manta, social media reports said.
Ecuador's presidency reported that "there are injured people who are being treated promptly in hospitals," but did not provide any figures.
- Remain 'calm' -
President Guillermo Lasso traveled to El Oro, where he visited the wounded in a hospital, and will next head to Azuay.
"I have just finished visiting the city of Machala... I have ratified government support, the availability of resources," he said in a video posted on Twitter.
Earlier in the day he urged people to remain "calm and to be informed through official channels" about damage to buildings.
According to Quito's Risk Management Office, the facade of a house collapsed on a vehicle and left "a deceased person" in Cuenca. AFP journalists in the city also reported that old houses in the historic center had been damaged.
Roads near Cuenca were additionally blocked by landsides.
Nearby, in the province of El Oro, three people were reported dead when a tower toppled and fatally crushed them.
The earthquake shook the north and central coasts of Peru with less intensity. In Tumbes, it damaged 12 homes, according to an official report.
"It is a relatively high magnitude for what we have in the country," said Mario Ruiz, director of the Ecuadorian Geophysical Institute in an interview with FM Mundo radio.
Peruvian seismological authorities initially reported a magnitude of 7.0, but hours later downgraded the magnitude to 6.7.
A first aftershock of magnitude 4.8 was recorded in Balao, Ecuador. The Ecuadoran navy said there was no tsunami threat.
In 2016, a quake with a magnitude of 7.8 hit Ecuador's western provinces of Manabi and Esmeraldas, killing 673 people and causing an estimated $3 billion in damage.
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