Shoes and blood-soaked clothing were strewn around the accident site, and mangled train cars that shot off the tracks were overturned on the edge of a cornfield.
Egypt's official Middle East News Agency quoted Minister of Health Hatem el-Gabaly on the death toll for the accident that occurred around 7:00 a.m. (0400 GMT) outside the town of Qalyoub, 20 kilometers (12 miles) north of the capital Cairo. El-Gabaly said four of the wounded were in critical condition.
Both trains were southbound and carrying commuters to Cairo from the Nile Delta towns of Mansoura and Benha.
The train from Mansoura was going at least 80 kilometers (50 miles) per hour when the collision occurred after it failed to heed a stop signal outside a Qalyoub train crossing, police sources said speaking on condition of anonymity because they were not authorized to give statements to the media. The stop signal was still blaring Monday afternoon.
The driver of the Mansoura train was killed, and the locomotive overturned when it crashed into the other train, police said.
Civil defense, police and the military worked together throughout the day to search for survivors and recover bodies amid the crumpled and charred cars. By late afternoon, they were using cranes to remove the twisted wreckage from the tracks and unblock the key rail route.
A man's lifeless and bloodied forearm with a watch was visible emerging from a crushed car.
"I carried so many dead people, many of them were just body parts, my own clothes were soaked in blood," said Raslan Abdel-Aziz, armed forces mechanic.
Most of the passengers were poor men between the ages of 20 and 50 who began their commute to Cairo as early as 4:00 a.m. (0100 GMT). In a country of 73 million people where nearly half live in poverty, cheap train service is the only way for many people to travel.
About a third of the injured were taken to the Qalyoub Hospital. One of the wounded, Zaki Abdullah, 30, said the trains were old and full of dust.
"We fell on each other, and I couldn't see anything," the police officer said from his hospital bed. "I struggled to find my way through he people to get out of the train."
Another passenger Nasser Gafaar, 37, said it was difficult to escape the wreckage after the train car turned upside down.
"Flames from the other train were spreading. I fainted as soon as I managed to get out of the train," said Gafaar, who had cuts on his head and bruises on his leg.
Residents of buildings overlooking the tracks from one side, provided water for survivors and sheets to cover the dead.
Egypt has a history of serious train accidents, which are usually blamed on poorly maintained equipment. Many of those incidents have occurred in the Nile Delta.