Civilians were fired upon by tanks, quadcopter drones, and helicopters near the al-Alam roundabout, about 1km (0.6 miles) from the aid site, a spokesman for Gaza's Hamas-run Civil Defence agency, Mahmoud Basal, said. The Israel Defense Forces (IDF) said its troops fired shots after identifying suspects who moved towards them "deviating from the designated access routes".

Israel previously denied shooting Palestinians in a similar incident on Sunday which the Hamas-run health ministry said killed 31 people and injured nearly 200. Its denial was in direct contradiction to what dozens of civilian witnesses, NGOs, and health officials said. Following Tuesday morning's incident, the director of Nasser Hospital in Khan Younis, Atef Al-Hout, described 24 dead and 37 wounded arriving with gunshot injuries, saying Israeli forces had opened fire on "crowds of civilians waiting for aid in western Rafah." A foreign medic working in the area told the BBC it had been "total carnage" since 03:48 (01:48 BST) and that they had been overwhelmed with casualties. (BBC)