"Thirteen civilians at least were killed in shelling by regime forces on the centre of the town of Ariha in Idlib province," Syrian Observatory for Human Rights head Rami Abdel Rahman told AFP.
Dozens were also wounded in the shelling which struck the main market in the centre of the town.
Regime forces opened fire from positions they control on the edges of the town, Abdel Rahman said.
It was not immediately clear what triggered the shelling, but rebels control part of Ariha while regime forces man three checkpoints inside the town.
Activists termed the latest bloodshed a "massacre" and posted a video online showing people carrying corpses and body parts covered in blood as cries were heard in the background.
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