By Nidal al-Mughrabi and Emma Farge
CAIRO/GENEVA (Reuters) – Palestinian health authorities say Israel’s two-year-old ground and air campaign against Hamas militants in the Gaza Strip has killed more than 67,000 people, with nearly a third of the dead under the age of 18.
The war, triggered by the deadly October 7, 2023 Hamas attack on Israel, has focused on Gaza City since last month and the offensive has continued despite consultations on U.S. President Donald Trump’s new, 20-point plan for ending the conflict.
This explainer examines how the Palestinian toll is calculated, how reliable it is, the breakdown of civilians and fighters killed, and what each side says.
HOW DO GAZA HEALTH AUTHORITIES CALCULATE THE DEATH TOLL?
The latest detailed breakdown released by the Palestinian Ministry of Health on September 3 counted 19,424 deaths among children, accounting for 30% of the then-total of 64,232. Its overall tally has since climbed to 67,160 as of October 6.
The official ministry death toll dwarfs those killed in all previous bouts of fighting between Israelis and Palestinians in Gaza since 2005, according to data from Israeli human rights organisation B’Tselem.
In the first months of the war, death tolls were calculated simply by counting bodies that arrived in hospitals, and data included names and identity numbers for most of those killed.
In May 2024, the health ministry included unidentified bodies, which accounted for nearly a third of the overall toll. However, since October 2024, it has only encompassed identified bodies.
A Reuters examination in March of an earlier Gaza Health Ministry list of those killed showed that more than 1,200 families were completely wiped out, including one family of 14 people.
IS THE GAZA DEATH TOLL COMPREHENSIVE?
The numbers do not necessarily reflect all victims, as the Palestinian Health Ministry estimates several thousand bodies are under rubble and it does not count the 460 malnutrition-related deaths it has recorded amid a famine in North Gaza.
Official Palestinian tallies of direct deaths likely undercounted the number of casualties by around 40% in the first nine months of the war as Gaza’s healthcare infrastructure disintegrated, according to a peer-reviewed study published in The Lancet journal in January.
The U.N. human rights office also says the Palestinian authorities’ figure is probably an undercount.
The conflict deaths it has verified using its own methodology up to July 20 show that 40% were children and 22% were women.
A U.N. inquiry assessed last month that Israel had committed genocide in Gaza – citing the scale of the killings as one of the acts backing up its finding. Israel called the finding biased and “scandalous.”
HOW CREDIBLE IS THE GAZA DEATH TOLL?
Pre-war Gaza had robust population statistics and better health information systems than in most Middle East countries, public health experts told Reuters.
The U.N. often cites the health ministry’s death figures and says they are credible.
DOES HAMAS CONTROL THE FIGURES?
While Hamas has run Gaza since 2007, the enclave’s Health Ministry also answers to the overall Palestinian Authority ministry in Ramallah in the West Bank.
Gaza’s Hamas-run government has paid the salaries of all those hired in public departments since 2007, including in the Health Ministry. The Palestinian Authority pays the salaries of those hired before then.
WHAT DOES ISRAEL SAY?
Israeli officials have said previously that the death toll figures are suspect because of Hamas’ control over government in Gaza, and that they are manipulated.
The Israeli military says 466 of its soldiers were killed in combat, and 2,951 others wounded since its Gaza ground operation began on October 27, 2023.
It also says it goes to great lengths to avoid civilian casualties. It says Hamas uses Gaza’s civilians as human shields by operating within densely populated areas, humanitarian zones, schools and hospitals, a repeated accusation that Hamas denies.
The conflict began on October 7, 2023 when Hamas militants stormed across the border into Israeli communities. Israel says the militants killed 1,200 people, mostly civilians, and took 251 people into captivity in Gaza, of whom some 20 are thought to be still alive there.
HOW MANY OF THE DEAD ARE FIGHTERS?
The Palestinian Health Ministry figures do not differentiate between civilians and Hamas combatants, who do not wear formal uniform or carry separate identification.
The Israeli military said in January 2025 it had killed nearly 20,000 Hamas fighters. It has not provided an update since. Such estimates are reached through a combination of counting bodies on the battlefield, intercepts of Hamas communications and intelligence assessments of personnel in targets that were destroyed.
Hamas has said Israeli estimates of its losses are exaggerated, without saying how many of its fighters have been killed.
(Compiled by Emma Farge, Nidal al-Mughrabi, Ali Sawafta, James MacKenzie and Angus McDowall; editing by William Maclean, Peter Graff, Alexandra Hudson and Mark Heinrich)
