Videos published by China's state broadcaster CCTV showed houses destroyed with walls torn apart.
Rescue workers waded through rubble strewn across the ruins in the aftermath of the earthquake, footage showed, while some gave locals thick blankets to keep warm in subzero temperatures.
Surveillance images published by CCTV showed people running through a store's aisles as shelves shook violently, sending objects like toys tumbling to the ground.
"A total of 95 people have been confirmed dead and 130 others injured as of 3 pm (0700 GMT)," Xinhua news agency said.
More than a thousand houses have been damaged, Xinhua reported earlier.
The powerful quake struck Tingri county with a magnitude of 6.8 near the border with Nepal at 9:05 am, according to the China Earthquake Networks Center (CENC). The US Geological Survey reported the tremor as magnitude 7.1.
Sangji Dangzhi, whose supermarket in Tingri county suffered considerable damage, described the situation as "very serious" with ambulances taking people to hospital throughout the day.
"Here the houses are made from dirt so when the earthquake came... lots of houses collapsed," the 34-year-old, who returned home from Shigatse after the quake struck, told AFP by phone.
- 'Very strong tremors' -
CCTV reported that Tingri county and its surrounding areas "experienced very strong tremors, and many buildings near the epicentre have collapsed".
In the town of Lhatse, videos geolocated by AFP showed debris scattered in front of streetside eateries.
Chinese President Xi Jinping emphasised "the all-out search and rescue efforts, minimizing casualties to the greatest extent possible, properly resettling affected residents, and ensuring their safety and warmth through the winter", CCTV added.
Xinhua said that "local authorities are reaching out to various townships in the county to assess the impact of the quake".
Temperatures in Tingri are around minus 8 degrees Celsius (17.6 degrees Fahrenheit) and will drop to minus 18 this evening, according to the China Meteorological Administration.
Disaster relief aid, including cotton tents, quilts and items for high-altitude and frigid areas, had been dispatched by central authorities to areas impacted by the quake, Xinhua said.
The high-altitude county in the Tibet region is home to around 62,000 people and situated on the Chinese side of Mount Everest.
Tuesday's quake was the most powerful recorded within a 200-kilometre (124-mile) radius in the last five years, the CENC added.
- 'Shook quite strongly' -
As well as Kathmandu, areas around Lobuche in Nepal in the high mountains near Everest were also rattled by the tremor and aftershocks.
"It shook quite strongly here, everyone is awake," said government official Jagat Prasad Bhusal in Nepal's Namche region, which lies nearer to Everest.
But no damage or deaths had been reported so far and security forces have been deployed, Nepali home minister spokesman Rishi Ram Tiwari said.
Nepal lies on a major geological faultline where the Indian tectonic plate pushes up into the Eurasian plate, forming the Himalayas, and earthquakes are a regular occurrence.
In 2015, nearly 9,000 people died and more than 22,000 were injured when a 7.8-magnitude quake struck Nepal, destroying more than half a million homes.
Some tremors were felt in Bihar state in India but no injuries were reported.
Three people were killed and dozens injured after a 7.0-magnitude earthquake struck along the mountainous China-Kyrgyzstan border in January last year.
A quake in December 2023 in northwest China killed 148 people and displaced thousands in Gansu province.
That quake was China's deadliest since 2014, when more than 600 people were killed in southwestern Yunnan province.
In the December 2023 earthquake, subzero temperatures made the aid operation launched in response even more challenging, with survivors huddled around outdoor fires to keep warm.
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