Pictures from the scene show the wreckage of the train after its central carriages derailed, and rescue efforts from the teams of firefighters and emergency services at the site.
LATEST: Four dead and ten seriously hurt as train derails near Milan
An aerial view of the train after the derailment at around 7 am. Photo: Italian Fire Service
Only the central carriages were affected in the incident. Photo: Italian Fire Service
Firefighters search the dented wreckage. Photo: Italian Fire Service
90 firefighters were involved in recovery efforts. Photo: Italian Fire Service
The derailment occurred near the town of Pioltello, west of Milan where the train was heading. Photo: Piero Cruciatti/AFP
Scenes from inside the wreckage showed the extent of the damage. Photo: Italian Fire Service
Search and rescue efforts lasted for around two hours. Photo: Italian Fire Service
Emergency service workers transport one of the victims. Some of the injured received first aid treatment in a nearby field. Photo: Piero Cruciatti/AFP
Rescuers carry a victim on a stretcher. Photo: Piero Cruciatti/AFP
Emergency services provided helicopters to transport some of the most seriously injured to hospital. Photo: Piero Cruciatti/AFP
This video shows emergency services at work. Video: Crazy Boom/YouTube
Anyone looking for information about loved ones who may have been affected by the derailment can call one of two dedicated helplines: 02 7758 4184 or 02 7758 4892.