Officials said most bodies had been recovered from the sprawling moonscape that was once an Oklahoma City suburb, where the tornado steamrolled entire neighborhoods and two schools. Nine children were among those killed.
After wide fluctuations in the casualty estimates offered by officials, Oklahoma City police chief Bill Citty told a news conference Tuesday that 20 people had been killed in the suburb of Moore and four more elsewhere.
"All of the people that have been reported missing -- initially last night, about 48 -- all of those have been actually found except for, I think, a few left in Moore," Citty said, adding that the death toll could yet rise.
More than 100 people have been pulled out alive from under debris, said Terri Watkins of the Oklahoma Department of Emergency Management, and officials said more than 200 were injured in the hurricane-strength storm.
"It's unreal. It's so visceral," said 32-year-old accountant Roger Graham as he combed through the ruins of the three-bedroom home he shared with his wife Kalissa, a schoolteacher, recovering what he could.
Curtis Carver, a 20-year veteran of the US Marine Corps who served two years in Iraq, described his hometown as a "war zone" as he waited at a police checkpoint for permission to recover keepsakes from the ruins of his house.
"It was my home, my kids' home," said the 38-year-old father of two, both of whom escaped harm. Carver was not allowed past because his house was in an area still deemed too dangerous.
"Now it's gone. There's nothing left. It's a pile of sticks.... and they're keeping me away," he said.
The tornado was the strongest possible category, EF5, packing winds of more than 200 miles per hour (320 kilometers per hour), Kelly Pirtle of the US weather agency's Severe Storms Laboratory in nearby Norman told AFP.
The epic twister, two miles (three kilometers) across, flattened block after block of homes as it struck mid-afternoon Monday, hurling cars through the air, downing power lines and setting off localized fires in a 45-minute rampage.
As of late Tuesday nearly 20,000 people remained without power.
The epicenter of the tragedy was the Plaza Towers Elementary School, where frightened teachers and students huddled in hallways and bathrooms as the twister barreled through, and where some of the children died.
"I couldn't hear anything but people screaming and crying," Claire Gossett, 11, told The New York Times. "It felt like the school was just flying."
In televised remarks from the White House, US President Barack Obama made special mention of the young victims as he mourned those lost and promised to provide survivors with the help they need to find their footing.
"The people of Moore should know that their country will remain on the ground there for them, beside them as long as it takes for their homes and schools to rebuild," Obama said.
"There are empty spaces where there used to be living rooms and bedrooms and classrooms, and in time we're going to need to refill those spaces with love and laughter and community," he added.
Most of the widely scattered debris consisted of splinters of wood no more than a foot (30 centimeters) long and other building debris. Bigger objects were few and far between.
Here and there were touchingly personal items: a bicycle wheel, a baseball mitt, a golf ball, a red Christmas stocking, a black wig.
Volunteers helped residents unearth official paperwork like passports and tax declarations, but also collectibles such as Star Wars memorabilia and part of a coin collection, said Michael Albrecht, who was in town for a company meeting when the tornado struck and decided to help the recovery.
Monday's tornado followed roughly the same track as a May 1999 twister that killed 44 people, injured hundreds more and destroyed thousands of homes.
Tornadoes often stalk Oklahoma's wide open plains, but Monday's twister struck a populated urban area. Because of the hard ground, few homes here are built with basements or storm shelters in which residents can take cover.
Oklahoma City lies inside the so-called "Tornado Alley" stretching from South Dakota to central Texas, an area particularly vulnerable to tornadoes.