State media said the quake caused the collapse of buildings in five cities and towns, as well as a railway bridge and a road bridge on the Yangon-Mandalay Expressway. Images showed the destroyed Ava Bridge over the Irrawaddy River, its arches leaning into the water.
A Mandalay resident said destruction stretched across the whole city, and one neighbourhood, Sein Pan, was on fire.
Roads were damaged, phone lines disrupted and there was no electricity, said the resident, who declined to be named.
At least three people died after a mosque in Taungoo partially collapsed, two witnesses said.
“We were saying prayers when the shaking started… Three died on the spot,” one said.
Local media reported a hotel in Aung Ban, in Shan state, crumbled into rubble, with the Democratic Voice of Burma reporting two people had died and 20 were trapped.