More than 480 people have also been injured, while rescue teams continue searching for people believed to be trapped beneath collapsed buildings.
The 7.4-magnitude earthquake struck at 07:34 local time on Monday at a depth of about 103km (64 miles), according to Colombia’s geological service.
The earthquake was centred near San José del Palmar in Chocó province, but the tremor was felt across a wide part of western Colombia, covering hundreds of miles.
Despite severe damage to roads leading into the area, the local mayor, León Fabio Marín Moncada, said there were no reported deaths or injuries in the village itself.
Pereira, in Colombia’s coffee-growing region, was among the worst-hit areas. The city is about 55km (34 miles) from the earthquake’s epicentre.
Videos verified by the BBC showed a building collapsing in Plaza Bolívar, Pereira’s main square. Dust and broken concrete could be seen spread across the area.
Officials said at least 40 people had died in Pereira’s metropolitan area, while 65 buildings had collapsed. Authorities believe people may still be trapped inside 15 of those buildings.
A curfew has also been introduced in some parts of the city, running until 05:00 local time on Tuesday.
The nearby city of Cali also suffered significant damage, with 32 buildings reported to have collapsed. Cali is about 160km south of Pereira and roughly 200km from the earthquake’s epicentre.
British visitor Dan Cutler, 29, who was staying in Cali when the earthquake struck, said he and his partner were suddenly awakened and ran outside in their pyjamas.
“We sprinted outside in our pyjamas. There’s no major structural damage to the hotel, but there are surface cracks in the walls, and paint and plaster have peeled off,” Cutler told the BBC.
Deaths were also reported in Manizales, Quibdó and Medellín, as well as other parts of Chocó and Valle del Cauca. At least two people were confirmed dead in Manizales.
Angélica Ávila, who was staying at a hotel in Manizales, said the walls began cracking as the earthquake hit.
‘Everyone was screaming… I saw dust coming out of the neighbouring buildings, and bricks were falling off the walls,’ she said.
Manizales journalist and meteorologist Luis Felipe Molina was also at home when the earthquake struck. His city is around 150km from the epicentre.
Molina said strict earthquake-resistant building rules introduced after previous earthquakes helped protect his building from serious damage.
However, the shaking was strong enough to knock almost all of the 450 books from his shelves, while glass broke and people screamed.
“I have 450 books and only a few were left standing on the shelves. You could hear glass breaking and people screaming. It was a terrible and terrifying experience,” he told BBC Mundo.
Several regional airports were also damaged, according to Colombia’s aviation authority. The affected airports included those in Pereira, Manizales, Quibdó, Armenia, Cartago and Buenaventura.
In Bogotá, the country’s capital, trees and traffic lights were seen shaking strongly. Some buildings developed cracks, but authorities said there was no major damage to the city’s infrastructure.
The earthquake was powerful enough to be felt in neighbouring Venezuela, Ecuador and Panama.
The disaster comes less than two months after two major earthquakes struck northern Venezuela, reportedly killing more than 6,300 people.
President Abelardo de la Espriella declared a national disaster, giving the government additional powers to respond to the crisis and move funds where they are most urgently needed.
The president, who had only taken office on Friday, said more than 1,500 homes had been damaged. The scale of the destruction is still being assessed as emergency workers continue rescue and recovery operations.
As the extent of the damage has begun to emerge, several countries have offered assistance to Colombia.
US Secretary of State Marco Rubio said the United States was closely following the situation and was prepared to provide support.
European Commission President Ursula von der Leyen said the EU’s Copernicus satellite system was being used to assist rescue efforts.
El Salvador’s President Nayib Bukele also expressed support for Colombia and offered to send rescue workers and equipment.
The US Geological Survey estimated that about 1.5 million people experienced shaking close to magnitude seven.
The agency said earthquakes that occur deep underground are generally less destructive than those closer to the surface.
However, deep earthquakes can still release large amounts of energy and cause serious damage to buildings. They also tend to produce fewer aftershocks, although some of those aftershocks can be powerful.
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