The Rehman Baba Express, travelling from Karachi to Peshawar, came off the tracks at around 5.15am local time near Sher Shah railway station in Punjab province. All 14 carriages derailed, with several overturning and trapping passengers inside.
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Rescue workers, police and local residents searched the wreckage, while cranes were brought in to remove damaged coaches. The injured were taken to Nishtar Hospital in Multan, where at least one person was reported to be in critical condition.
Pakistan Railways said all passengers had been evacuated. Train services on the affected line were suspended, and a relief train and medical unit were dispatched to the scene.
The cause of the accident remains unknown, and an investigation is under way. Prime Minister Shehbaz Sharif ordered authorities to accelerate rescue efforts and ensure proper medical care for those injured.
