The earthquake hit Pakistan and northern Afghanistan late on Friday, exactly two months after October 26 temblor in the same mountainous region that claimed the lives of more than 300 people.
Strong shocks were also felt in the Afghan capital Kabul at 11:14pm local time (1914 GMT).
Tremors were felt as far away as New Delhi, officials said. The quake was also felt in the Kashmir region.
The US Geological Survey said the earthquake, initially reported as magnitude 6.4, was at a depth of 126.5 miles (203 km) and centred 51 miles (82 km) southeast of the town of Feyzabad, capital of the Afghan province of Badakhshan.
According to earlier details, several cities including Rawalpindi, Peshawar, DG Khan, Mardan, Chitral, Swat and Muzaffarabad, Hafizabad, Vehari, Multan and others were shaken as a massive quake hit the country.
In Peshawar around 40 persons were injured when walls of several dilapidated buildings collapsed in the city. The injured were admitted at hospitals for medical attendance.
Ten persons were also injured in Hangu district of KP.
The earthquake tremors caused land slides in Ghzer area of Gilgit-Baltistan region leaving a woman dead and scores of other persons injured.
The epicenter of the earthquake was located closed to Afghanistan-Tajikistan border at a depth of 197 km, told DG Met Ghulam Rasool.
Earthquake tremors lasted for 59 secs, he added.
People terrified by the tremors came out of their houses reciting verses of Holy Quran and searched for safer places to avoid any harm.
According to Indian media, 6.5 magnitude tremors were also felt in New Delhi.