At least two people have been reported injured in the latest quakes, with the mayor of one mountain town saying that many buildings had collapsed as authorities rushed to assess the full extent of the damage.
The quakes were felt in the capital Rome, sending residents running out of their houses and into the streets. The second was felt as far away as Venice in the far north, and Naples south of the capital.
In both cases the epicentre was near the village of Visso in the central Marche region.
"Many houses have collapsed. Our town is finished," Marco Rinaldi, mayor of Ussita, told Sky Italy television by telephone.
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"The second quake was a long, terrible one," he said.
"I've felt a lot of earthquakes but that was the strongest I've ever felt. Fortunately everyone had already left their homes after the first quake so I don't think anyone was hurt."
In Rome, the quake rattled windows and doors, sending panicked people into the streets. The imposing foreign ministry headquarters was temporarily evacuated.
"For the moment, there are two people injured in Visso. Collapses and damage have also been reported," the civil protection department said.
"There is no electricity. There are bound to be house collapses. On top of this there are torrential rains," Castel Sant'Angelo's mayor Mauro Falcucci told Sky.
The little town of some 300 people is near Arquata del Tronto, one of the areas worst hit in the August 24 earthquake.
In Ascoli, another town hit hard in August, the mayor said spooked residents were fleeing by car.
"Aftershocks can last for a long time, sometimes for months," geologist Mario Tozzi said.
Visso's mayor Giuliano Pazzaglini said telephone links in his town had been restored. But television images showed rubble piled outside a local church.
August's disaster caused an estimated four billion euros (USD 4.5 billion) of damage, with 1,400 people still living in temporary accommodation.