Which areas of Italy were affected by the quake?
Castelsantangelo sul Nera, Visso, Ussita and Preci, in the province of Macerata, were the areas worst hit.
The epicentres of the quakes were near the village of Visso, located on the edge of the region of Marche close to the border with Umbria.
However, tremors were felt as far afield as Naples, Venice and Rome, and in the Italian capital, checks are being carried out to establish if the quake caused damage to any Roman buildings or cultural sites.
Was anyone hurt?
According to initial reports, dozens of residents have been treated for minor injuries and shock, but no serious casualties have been reported. One man in his 70's was reported to have died of a heart attack, however it wasn't clear if this was directly linked to the tremors.
"Given the strength of the shocks the absence of any deaths or serious injuries, which we hope will be confirmed, is miraculous," Interior Minister Angelino Alfano said.
The fact that there was an initial, weaker earthquake, which sent many people rushing out of their homes, likely saved lives from the second, much stronger tremor.
What damage has been caused?
Sadly, a huge amount of damage has been done to the area. Thousands of people are unable to stay in their homes and spent Wednesday night sleeping in their cars, at local gyms or other emergency accommodation, and even in tent camps - despite heavy rain.
The mayor of Ussita said: "The town is finished."
The civil protection agency is planning to reopen tent camps set up after the August earthquake but they will only provide a temporary solution as winter approaches. Many mountain villages in the area are located at over 600 m (2,000 feet) altitude and overnight temperatures will soon be falling below freezing.
The agency fears that up to 3,000 people may have been displaced by the earthquake; checks are being carried out on buildings to assess their stability.
The rich cultural heritage of the region has also suffered, with several medieval churches collapsing. Italy's Ministry of Cultural Heritage has set up a crisis unit to assess the level of damage.
Was there any connection to August's earthquake in Amatrice?
The region - one of Italy's most seismically vulnerable - has experienced thousands of aftershocks following the deadly quake on August 24th. Most have been of an extremely low magnitude, but others have caused further damage to the region and hampered recovery efforts.
But was this an aftershock - or something more?
Geologist Mario Tozzi said, from Italy's national geophysics institute, told AFP on Thursday that this was a "new earthquake" rather than an aftershock, after earlier suggesting the opposite.
"What we do not know is whether it was a dormant section of the Amatrice fault or a parallel structure, a close cousin of this fault," he added.
What's more, Wednesday night's tremors caused further damage in towns such as Amatrice and Arquata del Tronto, which were still reeling from the August disaster. The 'palazzo rosso' (red building), a four-storey building in Amatrice, collapsed on Wednesday night, along with the city hall.
The palazzo, which houses a bank, had been one of the few buildings left standing in the historic centre and its distinctive red colour had made it a symbol of the city. Amatrice's 13th-century clock tower, however, remains standing.
How will the region recover?
This question is the hardest to answer. August's disaster caused an estimated four billion euros ($4.5 billion) of damage and ome 1,400 people made homeless are still living in temporary accommodation. Renzi's government has drawn up a detailed recovery plan, and pledged to make the towns "even more beautiful than before".
The latest quake has not caused as much damage as that in August, by a long way. This is partially due to the fact that the earlier quake took place at the height of the summer season, when many usually empty second homes were occupied.
But the ongoing efforts to restore L'Aquila, another region hit by a deadly earthquake in 2009, have been the subject of repeated protests. Huge amounts of money have been pumped into the town and 95 percent of the suburbs have been rebuilt, but the historic centre remains a ghost town and the town's economy has not recovered.
A successful recovery plan for central Italy will need to include aid for affected businesses, assistance for schools, and upgrades to buildings to ensure they are able to withstand future tremors.
And of course there are some things which can't be rebuilt.
Residents will be reeling from the loss of family homes, possessions and memories of their hometown for many years to come.
The Italian Red Cross shared contact details and its bank account, for anyone who wishes to donate to recovery efforts.