Douma: At least 18 people were killed and more than 100 injured in Syrian government air strikes near the capital Damascus on Sunday, a monitor said.
The raids on the town of Douma, northeast of the capital, came as the conflict entered its fifth year and the death toll soared over 215,000.
The Syrian Observatory for Human Rights said government warplanes had carried out four raids on Douma, leaving women and children among the injured.
The Britain-based monitor said the toll was expected to rise because of serious injuries among the wounded.
An AFP photographer on the ground said the raids were continuing and that residents were sheltering in basements, terrified of the ongoing bombardment.
Douma lies in the opposition bastion area of Eastern Ghouta, which has been subject to massive regime aerial bombardment for months.
The area has also been under a crippling government siege for nearly two years as part of a regime bid to break the rebel hold in the region.
Rebels regularly fire missiles into the capital from the area.
Sunday marked the fourth anniversary of Syria`s conflict, which began with anti-regime protests in mid-March 2011 and spiralled into a bloody war after a harsh government crackdown on demonstrators.
The Observatory said Sunday that at least 215,518 people have since been killed in the conflict.