Gaza death toll may be 41% higher than official figures, study finds

The number of people killed in Gaza during Israel's deadly offensive in the Palestinian enclave is significantly higher than the figures reported by local health authorities, researchers at a leading health university in Britain have found.

In a peer-reviewed study published Thursday in The Lancet journal, researchers at the London School of Hygiene and Tropical Medicine said they estimated that as many as 64,260 people were killed in "traumatic injury deaths" in Gaza between Oct. 7, 2023 and June 30, 2024.

The authors of the study estimate that the death toll for the first nine months of the war was around 41% higher than the figure of 37,877 reported by the Palestinian health ministry.

Women, children under the age of 18 and people over 65 accounted for 59.1% of the 28,257 deaths for which age and sex data were available. Researchers did not provide an estimate of the number of Palestinian combatants killed. Health authorities in Gaza also do not publish data on militants killed.

The study suggests that the current death toll reported by Palestinian health authorities — at least 46,006 people killed as of Thursday — is also a significant undercount of the number of people killed during Israel's offensive.

"Although we only [analyzed] data up to June, 2024, the official [health ministry] estimate from Oct 7, 2023, to Oct 6, 2024, was 41,909," the study says, adding that if that level of under-reporting continued from July to October, 2024, it's possible that number of Palestinians killed in Gaza now exceeds 70,000.

"This is the most scientific understanding of what’s happening in the war of Gaza," Zeina Jamaluddine, the lead author of the paper told NBC News in a phone interview on Friday.

Jamaluddine said that while the Palestinian health ministry initially had robust electronic death records, those capabilities have deteriorated during Israel's 15-month-long campaign in the enclave, which has left much of Gaza's healthcare infrastructure damaged and destroyed.

As a result, she said, Palestinian health authorities have only been able to report the limited data they've been able to obtain throughout the war, with thousands of people still missing and believed to be buried under the rubble in Gaza.

In order to estimate the number of those killed in Gaza, the study's authors used a statistical sampling technique that is often used to estimate population size as well as death tolls during conflicts in Guatemala, Colombia and Sudan.

They also analyzed data from health ministry morgue records, online obituaries and an online health ministry survey, among other sources.

Palestinian health ministry figures have repeatedly come under scrutiny in the period since Israel launched its offensive in Gaza, mostly from Israeli officials. In May last year, the United Nations Office for the Coordination of Humanitarian Affairs changed its reporting methods for mortality in Gaza in an incident that sparked confusion and skepticism.

Israel launched its offensive following the Hamas-led Oct. 7 attacks, in which some 1,200 people were killed and around 250 taken hostage marking a major escalation in a decadeslong conflict.

Even so, major health authorities such as the World Health Organization have continued to express confidence in the data provided by Palestinian health officials.

Jamaluddine said she believed the study published Thursday reflects "that the numbers put forward by the [Palestinian] health ministry are accurate," and may be conservative as opposed to an inflation of the death toll in Gaza.

Israel, which is facing accusations of genocide in a case brought by South Africa before the International Court of Justice, has maintained that it does not intentionally target civilians in its Gaza offensive.

The study comes amid a string of deadly strikes by Israeli forces in Gaza, with 74 children reported by local health authorities to have been among those killed in the first seven days of 2025.

Video filmed by NBC News' crew on the ground captured the aftermath Tuesday night of a strike on a tent camp in the area of al-Mawasi, known as a humanitarian zone, that killed a mother, Haneen Abu Awad, and four of her children.

In the footage, four young children can be seen lying bloodied and motionless as their bodies — small enough to fit onto a single stretcher — are transported to a local hospital.

The Israel Defense Forces did not immediately respond to a request for comment on the incident.

As long as the deadly fighting in Gaza continues, Jamaluddine said a more thorough analysis of the death toll in the enclave would remain elusive. She added that ceasefire would be necessary to allow for a true assessment of the human toll of the war.