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Qingdao-bound train from Beijing derailed with 10 carriages toppled into a ditch in Zibo city and rammed into another train from Shandong's Yantai city to Xuzhou in the eastern Jiangsu province, a witness said.
Railway authorities said the accident had caused 43 deaths and injuries to 247 persons, an official news agency said.
Medical workers at the mishap site said "heavy casualties" were reported from both trains.
Witnesses said many passengers climbed out of the wrecked train after the accident.
Dozens of injured passengers were being treated at the Zhoucun People's Hospital and "more people are being sent in every hour," the agency quoted a hospital worker as saying over phone.
The accident has disrupted two-way traffic on the Jinan-Qingdao Railway, a pivotal provincial rail link.
This is the second major railway accident in Shandong this year after a high-speed train from Beijing to Qingdao ran over a group of railway workers in January, leaving 18 dead and nine others injured.
Source: DDNEWS