In the southern region hit hardest by the quake, emergency workers looked for survivors - or bodies - in the rubble of houses, churches and schools that were torn apart in the 8.1-magnitude quake.
President Enrique Pena Nieto said 45 people were killed in Oaxaca, 12 in Chiapas and four in Tabasco. But the actual death toll could be over 80, according to figures reported by state officials.
Meanwhile Hurricane Katia made landfall in the country's east, packing rains likely to cause "life-threatening flash floods and mudslides, especially in areas of mountainous terrain" the US National Hurricane Center said.
Adding to the concerns, authorities warned another massive quake could follow within 24 hours of the first hit.
Pena Nieto was speaking from the hardest-hit city, Juchitan in Oaxaca, where at least 36 bodies were pulled from the ruins.
The city's eerily quiet streets were a maze of rubble, with roofs, cables, insulation and concrete chunks scattered everywhere.
A crowd had formed at Juchitan's partially collapsed town hall, a Spanish colonial building where two policemen were trapped in the rubble.
"God, let him come out alive!" said a woman watching as four cranes and a fleet of trucks removed what remained of the building's crumbled wing.
His blue uniform covered in dust, Vidal Vera, 29, was one of around 300 police officers digging through the rubble. He hadn't slept in more than 36 hours.
"I can't remember an earthquake this terrible," he told AFP.
"The whole city is a disaster zone right now. Lots of damage. Lots of deaths. I don't know how you can make sense of it. It's hard. My sister-in-law's husband died. His house fell on top of him."
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