Strong tremors were felt in Pakistan, India, Nepal and Afghanistan on Tuesday at around 12:10 PM PST.
The latest earthquake hit near the town of Namche Bazar, near Mount Everest.
The US Geological Survey said it had a magnitude of 7.4. An earthquake on April 26, centred in east Nepal, had a magnitude of 7.8.
The latest tremor was felt as far away as the capital of India, Delhi, Pakistan as well as Dhaka, the capital of Bangladesh.
The epicentre of the latest earthquake was 83km (52 miles) east of Kathmandu, in a rural area close to the Chinese border.
It struck at a depth of 18.5km (11.5 miles), according to the US Geological Survey.
The 25 April quake was 15km (9.3 miles) deep. Shallower earthquakes are more likely to cause more damage at the surface.
The UN Office for the Co-ordination of Humanitarian Affairs warned that buildings had collapsed in Nepal.
At least 19 people were killed in Nepal, according to national police spokesman Kamal Singh Bam who put the number of injured at 679.
Four more were killed across the border in India, according to officials, while Chinese state media said one person was killed in Tibet.
The ground swayed for close to a minute from the first of Tuesday’s tremors, according to an AFP correspondent in Kathmandu.
“We felt it and suddenly there were huge crowds running up and down,” said resident Suresh Sharma, who was in a vegetable market at the time.
“It was very scary and very difficult to make my way out,” said 63-year-old.
“The last time we had the big quake I ran out of my house and barely escaped. This one felt just like that one. I can’t believe it’s happening again.”