An official identified by Sky TG24 as the president of the province of Andria said that rescue operations were continuing.
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The official says a boy, about 7, is among the injured, but does not have life-threatening injuries.
He appealed for blood donations and said: “There could still be someone in the wreckage”.
“This is a moment for tears in which we need to work to recover the victims and wounded”, he added.
There was no immediate indication of what had caused the two trains to be traveling towards each other on the same line and the Transport Ministry said it was dispatching two investigators to the region of Puglia to look into the disaster.
Italy’s national rail service, Ferrovia dello Stato, identified the company in a statement Tuesday, offering its condolences and support services.
The trains were operated by a private rail company, Ferrotramviaria, which connects the city of Bari with towns to the north and the airport. The line serves mostly students and commuters.
The four-car trains collided head-on near the town of Andria in Puglia, where trains operate on single tracks, authorities said.
A still photo of the crash showed cars crumpled together like an accordion and forced off the tracks at sharp angles.
Pictures of the mangled crash show the two trains veering sharply off the tracks, while a video shows rescue crews arriving on scene to pull survivors from the wreckage.
Prime Minister Matteo Renzi, who was attending the opening of a new science museum in Milan, said that he would return immediately to Rome.
At least 10 people died and dozens were injured when two passenger trains collided head-on in the southern heel of Italy on Tuesday, a spokesman for the fire service said.
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Several passengers are said to still be stuck inside the trains, reported the news agency.
