The Hamas-run health ministry says at least 27 people have been killed and 90 injured by Israeli fire while waiting for aid distribution in Rafah, southern Gaza.
The Israeli military says it fired shots near an aid complex after identifying "several suspects" and it is examining reports of casualties.
A medic in the area told the BBC of "total carnage" and being overwhelmed with casualties.
Israel denied shooting Palestinians in a similar incident on Sunday which the Hamas-run health ministry said killed 31 people and injured nearly 200.
Israel does not allow international news organisations, including the BBC, into Gaza, making verifying what is happening in the territory
difficult.
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