Photos from the scene just south of the city of Luodong showed the train’s eight cars in a zig-zag formation near the tracks. Five of the cars are turned over on their sides.
Most of the deaths were in the first car, which flipped over, a government spokesman said.
It was unclear how many people may still be trapped in the train, said the spokesman, who spoke on customary condition of anonymity. Some 120 soldiers joined firefighters in their rescue work.
On a live feed provided by Taiwan’s United Daily News, rescuers were seen carefully carrying what appeared to be a body wrapped in white plastic away from the site.
Local television reports said passengers were trying to escape through train windows and that bystanders had gathered to help them before rescuers arrived.
The Puyuma was launched in 2013 to handle the very difficult topography of Taiwan’s east coast and is distinct from the high-speed rail that runs on the west coast. The trains travel up to 150 kilometers (93 miles) per hour, faster than any other in Taiwan except for high-speed rail.
The train that derailed is 6 years old and its most recent inspection and major maintenance took place in 2017, Taiwan Railways Administration Director Lu Chie-shen said at a televised news conference.
Authorities are investigating the cause of the derailment.
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Associated Press writer Yanan Wang in Beijing contributed to this report.