Officials issued a tsunami warning for as far away as Sri Lanka.
The US Geological Survey said the temblor, which occurred at 11:09 pm local time (11:09 am EST), measured a magnitude of 8.2. A later reading put the magnitude at 8.7, said Paul Earle, a USGS research geophysicist.
Tsunami warnings were issued in Thailand, Japan and Sri Lanka, although officials in Thailand later called it off for that country. The only tsunami reported within four hours was a tiny one - less than 4 inches - at the Cocos Islands, 1,400 miles west of Australia, meteorologists in Sydney said.
The worst damage was reported on Nias Island, off the Sumatran coast, close to the epicenter of the earthquake, and dozens may be buried in the rubble, said Agus Mendrofa, deputy district head on the island.
"Hundreds of buildings have been damaged or have collapsed. People who were standing fell over", Mendrofa said. "We're not sure about casualties, but there may be dozens of people buried in the rubble."
UN disaster relief coordinator Jan Egeland said there were unconfirmed reports of deaths. "The hard-hit population of western Sumatra have been again struck by a very large earthquake," Egeland said.
Nias, a renowned surfing spot, was badly hit by the December 26 earthquake and subsequent tsunami that killed at least 175,000 people in 12 Indian Ocean nations and left another 106,000 missing. At least 340 residents of Nias perished and 10,000 were left homeless.
Indonesian officials said the quake's epicenter was 56 miles south of the island of Simeulu, off of Sumatra's western coast, and just north of Nias. It was described by one of the agency's geologists as an aftershock of the devastating December 26 quake.
An aftershock measuring 6.0 was reported in the same region nearly 30 minutes later, the USGS said.