At least 274 Palestinians were killed and hundreds more were wounded in the Israeli raid that rescued four hostages held by Hamas, Gaza's Health Ministry said Sunday. The military said its forces came under heavy fire during the complex daytime operation deep inside the territory.

The killing of so many Palestinians, including women and children, in a raid that Israelis celebrated as a stunning success because all four hostages were rescued alive, showed the heavy cost of such operations on top of the already soaring toll of the 8-month-long war ignited by Hamas' Oct. 7 attack.

Scores of hostages are believed to be held in densely populated areas or inside Hamas' labyrinth of tunnels, making rescue attempts extremely complex and risky. A similar raid in February rescued two hostages while leaving 74 Palestinians dead.

Israel rescues 4 hostages taken in Hamas' Oct. 7 attack, and 210 Palestinians are reported killed

The operation deep into Nuseirat, a built-up refugee camp in central Gaza dating back to the 1948 Arab-Israeli war, was the largest rescue since Oct. 7, when Hamas and other militants stormed across the border, killing some 1,200 people, mostly civilians, and taking around 250 hostage.

Israel launched a massive offensive that has killed over 36,700 Palestinians, according to the ministry, which does not differentiate between civilians and combatants in its counts.

It said nearly 700 people were wounded in Saturday's raid. The ministry did not say how many of the casualties were women and children, but Associated Press reporters saw several being treated at Al-Aqsa Martyrs Hospital in the nearby town of Deir al-Balah in the aftermath of the raid.

'MY BROTHER DIED OF GRIEF'

Israelis celebrated the return of Noa Argamani, 26; Almog Meir Jan, 22; Andrey Kozlov, 27; and Shlomi Ziv, 41, after Israeli forces raided two locations at once while under fire.

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Argamani was one of the most widely recognized hostages after being taken, like the three others, from a music festival. The video of her abduction showed her seated between two men on a motorcycle as she screamed, "Don't kill me!"

Her mother, Liora, who has brain cancer, had released a video pleading to see her daughter. Israel's Channel 13 said Argamani was moved to the hospital where her mother is treated.

Meir Jan's aunt, Dina, said his father had died on Friday, hours before the operation. "My brother died of grief, and he didn't get to see Almog return," she told Israel's Kan public broadcaster.

Dr. Itai Pessach, a physician at Sheba Hospital where the freed captives were being treated, said none had serious physical injuries but that it would likely be days before they could be discharged.

"A lot of them have lost friends and family. Things happened in these eight months that they weren't here. So (medical staff) have been assisting them in rebuilding the infrastructure of their life," he told reporters.

SCENES OF HORROR AT GAZA HOSPITAL

In Gaza, medics described scenes of chaos after Saturday's raid as wounded people overwhelmed hospitals that were already struggling to treat the wounded from days of heavy Israeli strikes in the area.

"We had the gamut of war wounds, trauma wounds, from amputations to eviscerations to trauma, to TBIs (traumatic brain injuries), fractures, and obviously, big burns," said Karin Huster of Doctors Without Borders, an international charity working in Al-Aqsa Martyrs Hospital, one of the facilities that received dead and wounded.

"Kids completely grey or white from the shock, burnt, screaming for their parents. Many of them are not screaming because they are in shock."

The Israeli military said it had attacked "threats to our forces in the area," and that a special forces officer was killed in the rescue operation.

Israel's military spokesman, Rear Adm. Daniel Hagari, told reporters Saturday that the hostages were being held in two apartments, about 200 meters (219 yards) away from each other, in the heart of the Nuseirat camp. He said the forces had trained repeatedly on a model of the apartment buildings.

Hagari said the forces moved in simultaneously in broad daylight on both apartments, believing this ensured the best element of surprise. But he said the rescuers came under heavy fire as they moved out, including from gunmen firing rocket-propelled grenades from within the neighborhood. He said the military responded with heavy force, including from aircraft, to extract the rescuers and freed hostages.

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Israel's Foreign Minister Israel Katz lashed out at critics of the operation in a post on X, saying "only Israel's enemies complained about the casualties of Hamas terrorists and their accomplices."

AROUND 120 HOSTAGES STILL MISSING

Of the 250 hostages abducted on Oct. 7, about half were released in a weeklong cease-fire in November. About 120 hostages remain, with 43 pronounced dead. Survivors include about 15 women, two children under 5 and two men in their 80s.

Saturday's operation brought the total number of rescued hostages to seven, including one who was freed shortly after the October attack. Israeli troops have recovered the bodies of at least 16 others, according to the government.

The latest rescue lifted some spirits in Israel as divisions deepened over the best way to bring hostages home. Many Israelis urge Netanyahu to embrace a cease-fire deal U.S. President Joe Biden announced last month, but far-right allies threaten to collapse his government if he does. Thousands of Israelis again gathered Saturday night to protest the government and call for a cease-fire agreement.

U.S. Secretary of State Antony Blinken will return to the Middle East this week, seeking a breakthrough. International pressure is mounting on Israel to limit civilian bloodshed in its war in Gaza. Palestinians also face widespread hunger because fighting and Israeli restrictions have largely cut off the flow of aid.