Emergency services in Valencia confirmed the death toll on Wednesday.
Rainstorms on Tuesday caused flooding in much of southern and eastern Spain.
Streams of mud-colored water hurled vehicles across the streets at frightening speeds. Pieces of wood were rotated with household items.
Police and emergency services used helicopters to get people out of their homes and cars.
Authorities reported several people missing late Tuesday, but the next morning brought the shocking news of dozens of dead bodies.
More than 1,000 soldiers from Spain’s emergency response units were deployed in the devastated areas.
“Yesterday was the worst day of my life,” Ricardo Gabaldón, mayor of Utiel, a city in Valencia, told national broadcaster RTVE.
He said several people were still missing in his town.
“We were trapped like rats. Cars and garbage containers lined the streets. The water was rising up to three meters,” he said.
Spain has experienced similar autumn storms in recent years, but nothing compared to the devastation of the past two days.
The death toll could easily rise with other regions yet to report casualties and search efforts continuing in hard-to-reach areas.
In the village of Letur in the neighboring Castilla-La Mancha region, Mayor Sergio Marin Sanchez said six people were missing.
A high-speed train with nearly 300 people on board derailed near Malaga, although railway authorities said no one was injured.
High-speed trains between Valencia and Madrid were disrupted, as were several city lines.
Valencia regional president Carlos Masson urged people to stay at home so as not to complicate rescue efforts, as road travel was already difficult due to fallen trees and wrecked vehicles.
“The neighborhood is destroyed, all the cars are on top of each other, it’s literally broken,” Cristian Viena, a bar owner in the Valencian village of Barrio de la Torre, said by phone.
“Everything is a complete wreck, everything is ready to be thrown away. The mud is almost 30 centimeters deep.
Spain’s central government has set up a crisis committee to help coordinate rescue efforts.
The rain had eased in Valencia by late Wednesday morning. But more storms were forecast until Thursday, according to Spain’s national weather service.
Spain is still recovering from a severe drought earlier this year. Scientists say more frequent episodes of extreme weather are likely linked to climate change.