Baluchistan province in south west Pakistan is the country’s largest but also the least populated.
Pakistani officials are investigating whether the powerful earthquake also created a new island off the southern coast.
More than two dozen houses collapsed in villages of Awaran district where the quake struck, said the district’s deputy commissioner Abdur Rasheed. He said rescue teams have been dispatched to the area.
The US Geological Survey reported the quake as magnitude 7.8.
It struck in a remote area of Baluchistan with little population, said the head of Pakistan’s Earthquake Centre, Zahid Rafi. He warned of possible aftershocks.
The quake was felt in Pakistan’s largest city, Karachi, along the Arabian Sea. People in the city’s tall office buildings rushed into the streets following the tremor.
“I was working on my computer in the office. Suddenly I felt tremors. My table and computer started shaking. I thought I am feeling dizziness but soon realized they were tremors,” said one Karachi resident, Mohammad Taimur.
Residents in Quetta, the capital of Baluchistan, came out of their homes and offices in a panic. Others said people started reciting verses from the Koran.
Baluchistan and neighbouring Iran are prone to earthquakes.
A magnitude 7.8, which was centred just across the border in Iran, killed at least 35 people in Pakistan last April.
In January 2011, a 7.2 magnitude quake damaged 200 mud-brick homes in a remote area of Baluchistan about 200 miles from Quetta, not far from the Afghan border but caused no casualties.
The Pakistan Meteorological Department’s director general, Arif Mahmood, said witnesses have reported that a small island has appeared near the port of Gwadar.
He says the quake could have caused the earth under the sea to rise, but officials need to investigate further.
Gwadar police chief Pervez Umrani said the new land mass is visible from the beach. He said the mass is about nine metres (30ft) high and 100 metres long.