The Israeli military says it has taken control of al-Shifa hospital in Gaza City in what it called an operation to "thwart terrorist activity".
It said troops killed 20 "terrorists", including a senior commander of Hamas's internal security force, and detained dozens of suspects during the raid.
Witnesses described heavy exchanges of fire around the site, where thousands of displaced people are sheltering.
Gaza's Hamas-run health ministry said Israel was committing a war crime.
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