At least six killed in train crash
Toll 'set to rise' after train hits landslide12 April, 11:26
The regional train, travelling on a single-line track through a mountain gully, apparently smashed into rocks before ricocheting into two pine trees that kept it from falling into the Adige river, rescue services said.
They said it was too early to say what the final toll might be.
"Keep still, everybody, we're still pulling the injured out," a conductor warned as the lead carriage shook.
Some of the 20 in hospital are reported to be in serious if not critical condition.
Line director Helmuth Moroder said the rockslide was probably caused when an irrigation pipe snapped. The accident took place not far from the city of Merano in the far-northern region of Trentino-Alto Adige.