The quake with a preliminary magnitude of 7.6 struck on Monday afternoon, prompting residents in some coastal areas to flee to higher ground as tsunami waves hit Japan's west coast, sweeping some cars and houses into the sea.
Buildings were toppled, roads wrecked and power cut to tens of thousands of homes.
A 3000-strong rescue crew of army personnel, firefighters and police officers from across the country have been sent to the quake site on the Noto peninsula in Ishikawa prefecture.
At least 48 people have died since the quake struck on the Noto peninsula in Ishikawa prefecture. (AP PHOTO)
"The search and rescue of those impacted by the quake is a battle against time," Prime Minister Fumio Kishida said during an emergency meeting on Tuesday, donning a blue outfit commonly worn by officials during disaster relief operations.
Kishida said rescuers were finding it very difficult to access the northern tip of the Noto peninsula where helicopter surveys had discovered many fires and widespread damage to buildings and infrastructure.Â
There are around 120 cases of people awaiting rescue, his government spokesperson later said.
Many rail services and flights into the area have been suspended. Noto's airport closed due to damage to its runway, terminal and access roads, with 500 people stranded inside vehicles in its parking lot, public broadcaster NHK reported.
In Suzu, a coastal town of just over 5000 households near the quake's epicentre, there may have been up to 1000 houses destroyed, according to its mayor Masuhiro Izumiya.
"The situation is catastrophic," he said.
Authorities have confirmed 48 deaths so far, all in Ishikawa prefecture, NHK reported. Many of those are in Wajima, another hard-hit city on the remote northern tip of the Noto peninsula.
Scores more have been injured and authorities were battling blazes in several cities on Tuesday and hauling people from collapsed buildings.
"I've never experienced a quake that powerful," said Wajima resident Shoichi Kobayashi, 71, who was at home having a celebratory New Year's dinner with his wife and son when the quake struck.
"Even the aftershocks made it difficult to stand up straight," he said, adding his family slept in their car for fear of returning to the shaken home.
Tsunami waves hit Japan's west coast after the earthquake, sweeping cars and houses into the sea. (EPA PHOTO)
More than 140 tremors have been detected since the quake first hit on Monday, according to the Japan Meteorological Agency, which warned more strong shocks could hit in the coming days.
Nobuko Sugimori, a 74-year-old resident of Nanao city in Ishikawa, told Reuters she had never experienced such a quake before.
"I tried to hold the TV set to keep it from toppling over, but I could not even keep myself from swaying violently," Sugimori said from her home which had a large crack down its front wall and furniture scattered around the inside.
Several world leaders sent condolence messages with US President Joe Biden saying in a statement the United States was ready to provide any necessary help to Japan.
The Japanese government ordered around 100,000 people to evacuate their homes on Monday night, sending them to sports halls and school gymnasiums, commonly used as evacuation centres in emergencies.
Almost half of those evacuated had returned to their homes on Tuesday after authorities lifted tsunami warnings.
But around 33,000 households remained without power in Ishikawa prefecture on Tuesday after a night when temperatures dropped below freezing, according to Hokuriku Electric Power's website. Nearly 20,000 homes have no water supply.
The Imperial Household Agency said it would cancel Emperor Naruhito and Empress Masako's slated New Year appearance on Tuesday following the disaster. Kishida postponed his New Year visit to the Ise Shrine scheduled for Thursday.
Japan's defence minister told reporters on Tuesday that 1000 army personnel are currently involved in rescue efforts and that 10,000 could eventually be deployed.
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