Rescue teams from neighbouring provinces were dispatched to the affected areas, working in the dark with floodlights in the freezing cold, and Defence Minister Hulusi Akar said troops were on standby to help.
Hundreds of residents were left homeless or with damaged homes.
TV footage showed rescuers pull out one injured person from the rubble of a collapsed building in the district of Gezin, in the eastern Elazig province.
Interior Minister Suleyman Soylu said emergency workers were searching for 30 people trapped under the rubble.
The quake struck at 8:55pm local time (17:55 GMT), at a depth of 6.7km (4.1 miles) near the town of Sivrice in Elazig, the Disaster and Emergency Management Presidency, or AFAD, said. It was followed by several aftershocks, the strongest with magnitudes 5.4 and 5.1.
Elazig is some 750km (465 miles) east of the capital, Ankara.
AFD said sixteen people were killed in Elazig and four more in the neighbouring province of Malatya. Some 920 injured were in hospitals in the region, it added.
Some 30 buildings had collapsed from the quake in the two provinces, according to Murat Kurum, the environment minister.
Turkish President Recep Tayyip Erdogan said on Twitter that all measures were being taken to "ensure that the earthquake that occurred in Elazig and was felt in many provinces is overcome with the least amount of loss."
People in Elazig whose homes were damaged or were too afraid to go indoors were being moved to student dormitories or sports centre amid freezing conditions.
6,8 büyüklüğünde bir deprem Cuma günü Türkiye'nin doğusunda çok az yer kaplayan en az 20 kişinin ölümüne, 900'den fazla kişinin yaralanmasına ve ayrılmasına neden oldu.
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