The Israeli military says it is carrying out a "precise and limited mission" in Nasser hospital in Khan Younis.
The Israel Defense Forces says it has "credible intelligence", including from released hostages, that Hamas held hostages at the hospital in southern Gaza.
It adds that it has apprehended a number of suspects, after earlier claiming that "terrorists appear to have been operating from within the hospital". Hamas has dismissed Israel's claims as "lies"
The IDF adds that it contacted the director of the hospital on Tuesday calling for the immediate end of "all Hamas terrorist activity" within the facility.
Gaza's Hamas-run health ministry says Israel forced people to leave, as well as using a bulldozer to demolish a wall and turn the hospital into a barracks.
Footage shows medical staff working under gunfire, with Nasser hospital sources telling the BBC one patient has been killed.
Israel ordered civilians sheltering at the hospital to leave on Wednesday.
Doctors at the hospital say a number of people have been killed by Israeli sniper fire there in recent days.
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