The quake hit at 9:59 p.m. (1359 GMT) Tuesday, centered 21 kilometers (13 miles) northeast of Bogo City in Cebu province at a shallow depth of 5 kilometers (3 miles), according to the Philippine Institute of Volcanology and Seismology (Phivolcs).
The US Geological Survey initially measured the quake at magnitude 7.0 before revising it to 6.9.
Local officials said 27 people were killed in Bogo City, with additional casualties reported in San Remigio and nearby towns.
The Pacific Tsunami Warning Center confirmed there was no significant tsunami risk.
Authorities warned the death toll may rise as rescue operations continue. Search and rescue teams have been deployed across affected areas while aftershocks persist.
The quake caused major structural damage. A sports complex collapsed in northern Cebu during a basketball game, killing and injuring spectators. The St. Peter and Paul Church on Bantayan Island also collapsed, and a fast-food restaurant in Bogo was partially destroyed.
Classes were suspended on Wednesday in several Cebu localities, including Lapu-Lapu, Mandaue, Talisay, Minglanilla, Consolacion and Liloan.