At least five people, including a four-month-old baby, have been killed after dozens of tornadoes ripped through Oklahoma, Iowa, Texas and Missouri causing serious damage.
Tens of thousands of residents were left without power following separate storms that began on April 26.
Four of the deaths happened in Oklahoma, where a state of emergency has been declared in a dozen counties.
A fifth person died from their injuries in Iowa after a separate storm system hit the Midwest, local media reported.
The National Weather Service (NWS) said a preliminary investigation had confirmed some of April 27 tornadoes had gusts of above 136 miles an hour.
The storms – which swept from Texas to Missouri – also saw up to seven inches of rain fall in some places within hours, the AFP news agency reported.
The town of Sulphur, in eastern Oklahoma, was hit particularly hard. Video of the aftermath showed flattened homes and overturned vehicles.
According to the Oklahoma State Department of Health, around 100 injuries were reported.
The towns of Holdenville and Marietta were also badly damaged.
The speaker of the Oklahoma state House of Representatives, Charles McCall, insisted that the affected areas would recover.
“We will rise, we’ll clean up, we’ll rebuild and we’ll move forward,” he told a news conference in Sulphur on April 28.
Oklahoma Governor Kevin Stitt also visited the town and said the damage there was the worst he had seen in his six years in office.
“You just can’t believe the destruction,” he said.
“It seems like every business downtown has been destroyed.”
The White House said President Joe Biden had spoken with Governor Stitt and offered the federal government’s full support.
It comes after a separate weather system brought more than 70 tornadoes to the Midwestern states of Nebraska and Iowa on April 26.
