Thousands of heavily armed police and soldiers barged past barricades into the capital's most violent areas clashing with defenders of a gang leader sought by the United States.
Officials say at least 30 are dead, many of which are thought to be civilians.
The police and armed forces are looking for Christopher "Dudus" Coke. Despite a daylong assault Coke is still at large.
The United States want him extradited on gun running and drug charges.
Gunfire echoed across the neighbourhoods in Jamaica's south coast - far away from the all-inclusive tourist resorts of the north.
Prime Minister Bruce Golding's office announced that officials were hoping to head to Tivoli Gardens to independently "ascertain the precise number of persons who have been killed or injured" there.