Rescue teams were still pulling bodies from the rubble of a hospital in Kabul on Tuesday morning after Afghan officials said an overnight airstrike blamed on Pakistan killed at least 400 people.

The strike also left around 250 injured when it hit the Omid Addiction Treatment Hospital, a major drug rehabilitation center in the capital. Authorities said large section of the facility were destroyed, and the death toll could rise as recovery efforts continued.

Pakistan denied targeting any civilian site, saying its air operation focused on military-related installations. Officials said strikes were also carried out in eastern Afghanistan, including Nangarhar.

The attack marks a significant escalation in tensions between Afghanistan and Pakistan, following weeks of cross-border clashes. International appeals for a ceasefire have so far failed to ease the conflict.

Afghan spokesperson Zabihullah Mujahid condemned the strike, accusing Pakistan of targeting civilian facilities and calling it a violation of humanitarian norms.

Pakistan rejected the accusations. Information Minister Attaullah Tarar said the military carried out “precision strikes” against infrastructure allegedly used by militant groups, insisting no civilian locations were hit.

The airstrike came hours after reports of cross-border fighting that left several people dead, as hostilities between the two neighbors entered a third week.

The escalation has raised concern among global leaders. The United Nations Security Council has urged Afghan authorities to step up action against militant groups, amid ongoing accusations by Pakistan that Afghanistan shelters insurgents—claims Kabul denies.

The situaiton highlights growing instability in the region, where groups such as al-Qaida and Islamic State continue to operate.