JERUSALEM (NewsNation Now) —  Hamas militants fired dozens of rockets into Israel on Monday, including a barrage that set off air raid sirens as far away as Jerusalem, after hundreds of Palestinians were hurt in clashes with Israeli police at a flashpoint religious site in the contested holy city.

The rocket fire drew heavy Israeli retaliation in the Gaza Strip. Health officials said at least 20 people, including nine children, were killed in fighting, making it one of the bloodiest days of battle between the bitter enemies in several years.

The fighting escalated already heightened tensions throughout the region following weeks of confrontations between Israeli police and Palestinian protesters in Jerusalem. Those confrontations, focused around a disputed hilltop compound in Jerusalem’s Old City, have threatened to spark a wider conflict.

Abu Obeida, spokesman for Hamas’ military wing, said the rocket attack was a response to what he called Israeli “crimes and aggression” in Jerusalem. “This is a message the enemy has to understand well,” he said.

He threatened more attacks if Israel again invades the sacred Al-Aqsa compound or carries out evictions of Palestinian families in a neighborhood of east Jerusalem.

Prime Minister Benjamin Netanyahu accused Hamas of crossing a “red line” with the rocket attack on Jerusalem, some 100 kilometers (60 miles) north of Gaza, and promised a tough response.

“Whoever attacks us will pay a heavy price,” he said, warning that the fighting could ”continue for some time.”

In Washington, State Department spokesman Ned Price condemned “in the strongest terms” the rocket fire on Israel and called on all sides to calm the situation.

At her regular White House press briefing, White House press secretary Jen Psaki said, “we are continuing to closely monitor the violence in Israel. We have serious concerns.”

Earlier, Israeli police firing tear gas, stun grenades and rubber bullets clashed with stone-throwing Palestinians at the iconic compound.

More than a dozen tear gas canisters and stun grenades landed in the Al-Aqsa Mosque, one of Islam’s holiest sites, as police and protesters faced off inside the walled compound that surrounds it, said an Associated Press photographer at the scene. Smoke rose in front of the mosque and the iconic golden-domed shrine on the site, and rocks littered the nearby plaza. Inside one area of the compound, shoes and debris lay scattered over ornate carpets.

Shortly after the sirens sounded, explosions could be heard in Jerusalem. One rocket fell on the western outskirts of the city, lightly damaging a home and causing a brush fire. The Israeli army said one rocket was intercepted and the others fell in open areas.

Israel was responding with airstrikes on Hamas targets throughout Gaza. The army said rocket launchers and eight militants had been targeted.

In Gaza, health officials reported a total of 20 deaths, including nine children.

In an apparent attempt to avoid further confrontation, Israeli authorities changed the planned route of a march by ultranationalist Jews through the Muslim Quarter of the Old City. The marchers were ordered to avoid the area and sent on a different route circumventing the Muslim Quarter on their way to the Western Wall, the holiest site where Jews can pray.

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But tensions remained high.

More than 305 Palestinians were hurt, including 228 who went to hospitals and clinics for treatment, according to the Palestinian Red Crescent. Seven of the injured were in serious condition. Police said 21 officers were hurt, including three who were hospitalized. Israeli paramedics said seven Israeli civilians were also hurt.

The confrontation was the latest after weeks of mounting tensions between Palestinians and Israeli troops in the Old City of Jerusalem, the emotional center of their conflict. There have been almost nightly clashes during the Muslim holy month of Ramadan, already a time of heightened religious sensitivities.

Most recently, the tensions have been fueled by the planned eviction of dozens of Palestinians from the Sheikh Jarrah neighborhood of east Jerusalem where Israeli settlers have waged a lengthy legal battle to take over properties. Monday was expected to be particularly tense since Israelis mark it as Jerusalem Day to celebrate their capture of east Jerusalem in the 1967 Mideast war.

On Monday, two anti-Arab members of Israel’s parliament, surrounded by an entourage and police, pushed through a line of protesters in the Sheikh Jarrah neighborhood. Several Arab members of parliament were among those trying to stop Betzalel Smotrich and Itamar Ben Gvir, amid shouting and jostling. Smotrich and Ben Gvir eventually got to the other side of a police barricade and entered a house already inhabited by settlers.

Over the past few days, hundreds of Palestinians and several dozen police officers have been hurt in clashes in and around the Old City, including the sacred compound, which is known to Jews as the Temple Mount and to Muslims as the Noble Sanctuary. The compound which has been the trigger for rounds of Israel-Palestinian violence in the past, is Islam’s third-holiest site and considered Judaism’s holiest.

An AP photographer at the scene said that early Monday morning, protesters had barricaded gates to the walled compound with wooden boards and scrap metal. Sometime after 7. a.m., clashes erupted, with those inside throwing stones at police deployed outside. Police entered the compound, firing tear gas, rubber-coated steel pellets and stun grenades.

At some point during the morning about 400 people, both young protesters and older worshippers, were inside the carpeted Al-Aqsa Mosque. Police fired tear gas and stun grenades into the mosque.

Police said protesters hurled stones at officers and onto an adjoining roadway near the Western Wall, where thousands of Israeli Jews had gathered to pray.

The tensions in Jerusalem have threatened to reverberate throughout the region.

Before Monday’s rocket attack on Jerusalem, some 100 kilometers (60 miles) north of Gaza, Palestinian militants had fired several barrages of rockets into southern Israel. Protesters allied with the ruling Hamas militant group have launched dozens of incendiary balloons into Israel, setting off fires across the southern part of the country.

The rare strike on Jerusalem came moments after Hamas had set a deadline for Israel to remove its forces from the mosque compound and Sheikh Jarrah and release Palestinians detained in the latest clashes.

Hamas, an Islamic militant group that seeks Israel’s destruction, has fought three wars with Israel since it seized power in Gaza in 2007. The group possesses a vast arsenal of missiles and rockets capable of striking virtually anywhere in Israel.

The rocket strike on Jerusalem was a significant escalation and raised the likelihood of a tough Israeli response.

After several days of Jerusalem confrontations, Israel has come under growing international criticism for its heavy-handed actions at the site, particularly during Ramadan.

The U.N. Security Council scheduled closed consultations on the situation Monday.

Late Sunday, the U.S. National Security Adviser Jake Sullivan spoke to his Israeli counterpart, Meir Ben-Shabbat. A White House statement said that Sullivan called on Israel to “pursue appropriate measures to ensure calm” and expressed the U.S.’s “serious concerns” about the ongoing violence and planned evictions.

Prime Minister Benjamin Netanyahu pushed back against the criticism Monday, saying Israel is determined to ensure the rights of worship for all and that this “requires from time to time stand up and stand strong as Israeli police and our security forces are doing now.”

In other violence, Palestinian protesters hurled rocks at an Israeli vehicle driving just outside the Old City walls. CCTV footage released by the police showed a crowd surrounding the car and pelting it with rocks when it swerved off the road and into a stone barrier and a bystander.

Police said two passengers were injured.

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The day began with police announcing that Jews would be barred from visiting the holy site on Jerusalem Day, which is marked with a flag-waving parade through the Old City that is widely perceived by Palestinians as a provocative display in the contested city.

But just as the parade was about to begin, police said they were altering the route at the instruction of political leaders. Several thousand people, many of them from Jewish settlements in the West Bank, were participating.

In the 1967 war in which Israel captured east Jerusalem, it also took the West Bank and Gaza Strip. It later annexed east Jerusalem and considers the entire city its capital. The Palestinians seek all three areas for a future state, with east Jerusalem as their capital.

The recent round of violence began when Israel blocked off a popular spot where Muslims traditionally gather each night during Ramadan at the end of their daylong fast. Israel later removed the restrictions, but clashes quickly resumed amid tensions over the planned eviction of Palestinians from Sheikh Jarrah.

Israel’s Supreme Court postponed a key ruling Monday that could have forced dozens of Palestinians from their homes, citing the “circumstances.”