New York City Mayor Mr Rudolph Giuliani said today four survivors and 55 dead bodies had been recovered and "a few thousand people" were believed to be trapped in the smoking ruins of the city's World Trade Center.
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The city's hospitals were bracing to take in huge numbers of casualties and said they were "absolutely mobbed" by blood donors, but said relatively few people had so far been rescued from the disaster zone and treated for injury.
"We so far we have a body count of 55 people, about a half hour ago," Mr Giuliani told a news conference shortly after 19:00 GMT.
"We were able to take out another person two or three hours ago, a woman who was found alive and taken to the hospital, so now there are at least four people we have been able to take out," he said.
"This is a situation we are going to be living with for a while, which is we will only know whether we have saved someone or recovered someone's body when that actually happens," he said.
He said about 300 firefighters and 70 police officers were missing since the World Trade Center's twin towers collapsed after being hit by two hijacked commercial airliners on yesterday morning.
Earlier today US television reports said seven survivors have been found.
Mr Giuliani said earlier this afternoon: "The best estimate that we can make, relying on the Port Authority and everyone else that has experience with this, is that there will be a few thousand people left in each building."
Ms Mary Johnson, spokeswoman for the Greater New York Hospital Association, said "around 2,000 people were registered" in hospitals in New York and adjacent New Jersey, but many were not formally admitted.
At the Pentagon in Washington, one official, speaking on condition of anonymity, said reports that as many as 800 people had been killed there were "completely inaccurate."
And Bryan Whitman, a Pentagon spokesman, said no estimates had been made on casualties.
A spokesman for New York's Saint Vincent's hospital said shortly after daybreak on today that "things were pretty slow" since few survivors had yet been dragged from the rubble.
At Bellevue Hospital, a spokesman said the hospital's dining room had been turned into a blood donor centre and was "absolutely mobbed" by donors.
Mr Giuliani estimated it would take two to three weeks to clear the debris.
He suggested the casualty toll would be higher in the northern tower, the first of the pair to be hit and the second to fall.
AFP