Aerial photographs revealed entire villages were flattened when severe tropical cyclone Winston struck overnight Saturday, lashing the Pacific island nation with gusts of 325 kilometres per hour.
"The images emerging from early aerial assessments of affected areas are truly heartbreaking, leaving little doubt about the ferocity of this cyclone," said the UN's Fiji coordinator Osnat Lubrani.
"It is clear from these catastrophic impacts that Fiji is facing a long road to recovery."
Photographs taken from a Royal New Zealand Air Force plane showed the devastation in remote villages that bore the brunt.
Many homes were reduced to piles of kindling, with roofing and furniture strewn about by winds that were strong enough to strip leaves and branches from trees.
In one image a lone man stands on the tin roof of his ruined home, apparently waving both arms at the military plane as it passes overhead.
The official body count went from six to 20 as communications were slowly restored to affected communities.
Oxfam's Pacific regional director Raijeli Nicole said Fijians were braced for more bad news.
"Given the intensity of the storm and the images we have seen so far, there are strong concerns that the death toll won't stop climbing today and that hundreds of people will have seen their homes and livelihoods completely destroyed," she said.
International tourists caught up in the disaster began to leave as flights resumed at Nadi airport after a two-day suspension.
Melbourne man Jeremy Bree told the Australian Broadcasting Corporation that he heard trees being ripped from the ground as he sat out the storm in a hotel on the main island Viti Levu.
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