A total of 380 buildings collapsed and thousands were damaged in Zhang county, according to an online post by the Dingxi local government. Communications were cut off in 13 towns in the county, the official Xinhua news agency said, and power was off in some areas.
The quake was felt in the provincial capital Lanzhou and as far away as Xian, the capital of the neighbouring province of Shaanxi, Xinhua reported.
People posting on China’s hugely popular microblogs expressed sympathy for the victims. “I hope the dead will rest in peace,” read one typical remark.
Beijing’s own China Earthquake Networks Centre put the magnitude of the larger quake at 6.6, it added.
The China Earthquake Administration said the same fault zone was linked to a magnitude 8.0 quake on July 21, 1654, Xinhua added.
The USGS rated Monday’s main tremor at seven on its “shakemap”, with shaking perceived to be “very strong” and the potential to cause “moderate” damage.
Weather reports also said rain was expected in the area, which could hamper rescue efforts in the mountainous region.
Disaster relief agencies have sent 500 tents and 2,000 quilts to the quake-hit area, Xinhua said.
Much of western China is prone to earthquakes.
A magnitude 6.6 earthquake in neighbouring Sichuan province killed about 200 people earlier this year, five years after almost 90,000 people were killed in a huge tremor in the same province.