The Palestinian Health Ministry said in the latest update that in addition to the 20 killed, another 155 were injured in the incident at the Kuwaiti roundabout in Gaza City.
The Ministry, which is run by Hamas, accused Israel of killing Palestinians while they were waiting for aid distribution.
"What happened at the Kuwaiti roundabout points to hidden intentions of the occupation to commit a new, horrible massacre," the Ministry said.
The Israel Defense Forces (IDF) rejected the claims that forces opened fire on civilians.
Israeli spokesperson Avichay Adraee said Palestinian gunmen opened fire as aid convoys were approaching.
"The IDF continues its investigations into what happened, while intensifying its efforts to bring humanitarian aid to the residents of the Gaza Strip," he said.
The incident echoes a late February tragedy in which more than 100 Palestinians were killed while waiting for aid in Gaza City.
That account, too, saw competing versions of what happened from both sides.
But it also led to the Biden administration launching bolstered efforts to get aid into Gaza, including airdrops and a plan to construct a pier off the shore of the territory.
Secretary of State Antony Blinken said Friday the U.S. remains committed to backing Israel but is also pushing for humanitarian protections for Gazans.
Blinken said the U.S. is working to ensure "more and better is being done to protect civilians in harm's way in Gaza, to get the humanitarian assistance they so desperately need to the children, to the women, and the men."
Read the full report at TheHill.com.
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