Shelling by ENDF killed 29 civilians in the city before capturing it.
New York Times reported that according to doctors, working at Ayder Referral Hospital, at least 27 civilians were killed during the shelling of the city on 28 November. The victims included a 4-year-old and injured over 100 people. The Interniational Red Cross warned already about limited supplies in the hospital and lack of body bags for the deceased. The head of the Tigray Health Bureau (who worked as a surgeon at Ayder on 28 November) reported to VOA that he had received 22 deadly victims and 40 wounded during that day and night. At least 2 of the injured died due to their wounds later on. He witnessed 2 airstrikes and multiple shelling on the city. According to HRW among the places hit was a residential area in Ayder area where shells killed 4 members of a single family, including 2 children and wounding 6 people. Another area hit is Kebele 15. One of the damaged buildings was the central market in Adi Haki. PM Abiy told the parliament on 30 November that during the 3 week long war not a single civilian lost its life on the hands of the ENDF. In the report by the Joint Investigation Team of OHCHR and EHRC, the federal government denied any allegation of using heavy artillery on Mekelle on 28 November.