A peer-reviewed study published in the Lancet Global Health journal has estimated that more than 75,000 people were killed in Gaza during the first 16 months of the war, a figure substantially higher than the toll announced by local authorities at the time. The research suggests the official count was understated by at least 25,000 deaths.
The study, based on a survey of 2,000 families, found that 42,200 women, children and elderly people died between 7 October 2023 and 5 January 2025, comprising 56% of violent deaths. It also indicated that 3-4% of Gaza's population had been killed violently during that period, with additional non-violent deaths caused indirectly by the conflict.
The exact death toll in Gaza has been fiercely disputed. However, last month a senior Israeli security officer reportedly told Israeli journalists that figures compiled by Gaza health authorities were broadly accurate, a marked reversal of earlier official criticisms. Gaza health authorities currently state that more than 71,660 people have been killed directly by Israeli attacks, including over 570 since the ceasefire that took effect in October 2025.
The research team, which included an economist, demographer, epidemiologist and survey specialists, based its findings on interviews with carefully selected representatives from 2,000 families. One of the authors, Michael Spagat, a professor of economics at Royal Holloway, University of London, emphasised the importance of having Palestinian pollsters conduct the sensitive survey. He noted that the study estimated 8,200 deaths from indirect causes such as malnutrition and untreated disease.
Spagat questioned an earlier Lancet study that estimated four indirect deaths for every direct death, arguing that such ratios vary greatly between conflicts. He pointed to Kosovo, where most deaths were violent, and Darfur, where the pattern was very different. In Gaza, he said, well-trained doctors and a functioning health system initially existed, and the territory's small size allowed aid to reach people when it flowed. He acknowledged that the number of indirect deaths was “much lower than what many people say and believe” but cautioned against desensitisation to the scale of loss.
The war began with a Hamas attack on Israel on 7 October 2023, which killed about 1,200 people, mostly civilians, and resulted in 250 hostages. Israel's subsequent assault devastated Gaza with airstrikes, tank shelling and artillery. The study covers the most intense and lethal period of the offensive but not the most acute phase of the humanitarian crisis; famine in Gaza was declared by UN-backed experts in August last year. Israeli officials have previously claimed that their attacks killed nearly equal numbers of combatants and civilians, a claim the new study contradicts.
