The tremor, with a magnitude of 6.4, centred on the town of Zarand about 700 km (440 miles) southeast of Tehran and revived painful memories of the devastating quake just 14 months ago in the nearby desert citadel city of Bam that killed 31,000 people. Distraught and weeping villagers carried dead bodies wrapped in bloodied blankets and bed sheets, and dug with their bare hands through mud and rubble in search of friends and relatives.
Hampered by cold, driving rain, which was turning to sleet and snow in some areas, relief teams bringing tents, blankets and warm food strived to reach remote villages where thousands of people were left homeless.
"We have done everything to make sure that people will not spend the night in the open air in the quake-stricken areas," Kerman province Governor Ali Karimi told state television.
"But evacuation is not yet complete in five villages which are in inaccessible, mountainous areas," he added.
Karimi put the death toll at 420 but said the figure would probably rise. Aid and medical workers had treated about 900 injured people, he said.
In the mountain villages surrounding Zarand groups huddled together in the cold, striking their heads and chests in grief. Some picked through the ruins of rubble and twisted corrugated sheeting in search of belongings. Others sat silently weeping in front of what used to be their homes.
"SAD SCENE"
"It's a very sad scene," Kari Egge, UNICEF representative in Iran, told Reuters by telephone from Douhan village, about 20 km (12.5 miles) from Zarand. "There's almost nothing left of the buildings."
While the mud-brick villages crumbled in the early morning tremor, major towns and cities in the area escaped heavy damage, meaning the death toll would not match the many thousands killed in Iranian quakes in the past, officials said.
Following Islamic tradition, villagers immediately began burying the dead, wrapped in white cloths.
"My whole family is dead," one man cried in images broadcast on state television.
Egge said survivors would need to move to nearby towns and villages to find shelter before nightfall.
"It's at 1,800 metres (5,400 feet) here. It's cold and has been raining. There's no shelter, nowhere for people to stay."
Karimi said 10,000 tents and 15 trailer loads of food had so far been distributed by teams of aid workers.
Some 40 villages, which had a combined population of about 30,000 people, were affected, local officials said.
Television showed nurses wiping blood from the faces of children in cramped and chaotic hospital hallways. Some of the injured were taken by train to Kerman where bandaged and crying children clutching bags of serum stood at the railway station.
Criss-crossed by major fault lines which make it one of the most earthquake-prone countries in the world, Iran said it had no need for international assistance.
The UN Office for the Coordination of Humanitarian Affairs agreed that local authorities, backed by the Iranian Red Crescent had the relief effort under control.
(Additional reporting by Paul Hughes, Parisa Hafezi, Hossein Jasseb and Amir Paivar in Tehran, Stephanie Nebehay in Geneva)