Initial reports indicate the quake was about 5.9 miles deep and roughly 13 miles from the city of Hualien, according to the U.S. Geological Survey.
At least 241 have been injured, the Central Emergency Operations Center told ABC News. About 20 of those people have serious injuries, according to the mayor of Hualien.
Four buildings have collapsed and two bridges were closed, the Central Emergency Operations Center also said.
Approximately 82 people remained missing, down from 183 earlier, authorities said.
Photos show a large mixed-use building heavily tilting. At least two fatalities occurred in this structure, the Hualien Fire Department told ABC News.
The Marshal Hotel was one of the buildings that collapsed, a fire department official said. There were more than 100 guests in the hotel at the time of the quake, and at least three remained trapped, the department said. Firefighters were continuing to deal with gas leaks and fires as a result of the quake.
Video shows rescuers helping people out of the building.