Many were crushed after panic broke out on a bridge near the Ratangarh temple in Madhya Pradesh state. Others died when they jumped from the bridge.
Officials said the stampede may have been sparked by a rumor that the bridge was about to collapse.
Hundreds of thousands had gathered near the town of Datia for the festival.
The narrow bridge is about 500 m long, and had only recently been rebuilt following another stampede in 2007.
Madhya Pradesh health minister Narottam Mishra said 89 people were confirmed to have died.
“The cause of the stampede is a matter of judicial inquiry. Information from locals suggests that rumors of the bridge giving way could have led to the stampede,” he said.
Other reports suggested that police sparked panic by using batons to control the crowd.
Officials said the dead included 42 women, 30 children and 17 men.
Emergency crews and specialist divers were still searching the river for bodies.
Local official Sanket Bhondve said the immediate priority was to provide relief to those injured.
The accident happened at about 09:00, but information was slow to emerge because the temple is in a remote area with erratic mobile-phone coverage.
Hindu festivals in India are notorious for deadly stampedes.
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