Syrian government air raids on rebel-held areas throughout the country have killed thousands over the past few years.
The air raids on the market in Douma occurred during rush hour when people were out shopping on the first working day of the week in Syria, the activists said.
"This is an official massacre that was carried out deliberately," said Rami Abdurrahman, who heads the Britain-based Syrian Observatory for Human Rights. He said warplanes fired the first missile and minutes later when people gathered in the aftermath, another missile hit the same area.
The Local Coordination Committees, another activist group, said the air raids killed at least 100 and wounded about 300, adding that rescue workers are digging through the rubble in search of survivors.
Discrepancies in death tolls immediately after an attack are not uncommon in Syria.
"The situation is catastrophic," a Douma-based activist who goes by the name of Mazen al-Shami told The Associated Press via Skype. He said clinics in the area are full and many of the wounded are being rushed in civilian cars to other medical facilities since ambulances are overwhelmed.
An amateur video posted online by activists showed some 40 bodies of men and boys lined on the side of a street as more bodies were being brought in. Another video showed people helping the wounded leave the heavily damaged market area.
The videos appeared genuine and corresponded to other AP reporting of the events.
Syria's civil war, now in its 5th year, has killed more than 250,000 people and wounded at least a million.
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