Downpours that pounded the region's flatlands over two days caused nearly two dozen rivers to burst their banks, putting vast stretches of territory under water and causing thousands of residents to be evacuated.
"We watched from the (second-floor) window as the water gradually rose," Cesena resident Davide Maeldolla told AFP, pausing from mucking out his inundated home, where the water had risen as high as 1.5 metres.
"The helicopters circled all night to rescue people."
IN VIDEOS: How floods devastated Italy's Emilia-Romagna region
In nearby Forli, southeast of the regional capital Bologna, Mayor Gian Luca Zattini said his city was "on its knees, devastated and in pain."
"It's the end of the world," Zattini said.
Regional authorities confirmed nine dead, with most in the area around Forli and Cesena.
Flooding occurred in 41 municipalities, while an even greater number reported landslides.
Thousands of farms in the fertile agricultural area were affected, but Agriculture Minister Francesco Lollobrigida said the water would have to subside before the government could quantify the damage.
Two of the bodies in Forli were recovered by divers on Wednesday morning, as part of a huge rescue effort involving emergency services, armed forces and over 1,000 volunteers.
Emilia Romagna, one of Italy's richest regions, had already been hit by heavy rain just a fortnight ago, causing severe floods that left two dead.
This time, around 50 centimetres (20 inches) of rain fell within 36 hours in Forli, Cesena and Ravenna - around half the normal annual rainfall, a situation "with few precedents", Italy's Civil Protection Minister Nello Musumeci said.
"It is still a very critical situation," he told reporters, adding that while the rain was still falling, it was expected to lighten during the day.
The flooding caused the cancellation of the Formula One Emilia Romagna Grand Prix, which had been set for on Sunday in Imola.
Organisers said they could not guarantee the safety of fans, teams and staff.
"It would not be right to put further pressure on the local authorities and emergency services at this difficult time," they said.
Regional President Stefano Bonaccini said Emilia Romagna had been hit "like an earthquake".
Rescue workers had worked through the night to save children, the elderly and the disabled from the rising waters.
"We're scared, this time we're scared," said Simona Matassoni, the owner of the Hotel Savio in Cesena, which has so far escaped flooding.
"I was born here, I've seen lots of full rivers, but never anything like this," she told AFP by telephone on Wednesday morning, adding that it was still raining.
"At the moment we're crossing our fingers... but another flood is expected, so who knows (what will happen)."
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Some 3,000 people had been evacuated from their homes in Bologna, while the mayor of Ravenna said some 5,000 people were being evacuated as a precaution.
50,000 homes were without electricity on Wednesday and some 100,000 mobile users were without service.
All rivers in the region had broken their banks between Tuesday and Wednesday.
The civil protection agency urged "maximum caution", as mayors warned people to stay on high ground.
In Forli, an AFP photographer saw people in a state of shock as they fled on Tuesday night through floodwaters in the dark in their bare feet.
Elsewhere, locals in Cesena swam down a road to rescue a three-year-old child and a man was seen wading through high water with his cat.
The heavy rains follow a drought that affected much of northern Italy last winter, and a record lack of rain last summer.
"We have to get used to it for the future, because unfortunately in recent years it often happens that these extreme rainfalls arrive," Air Force meteorologist Paolo Capizzi told AFP.
He said it could not directly be blamed on global warming but the "ever-increasing frequency of these phenomenon can obviously be the consequence of ongoing climate change".
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