The US Geological Survey (USGS) said the quake, which had a 6.6 magnitude, was centred 80km (50 miles) west of the town of Linqiong.
It said the tremor occurred at a depth of 12.3km (7.6 miles).
The latest quake - initially reported as a 7.0 magnitude, and then at 6.9 - struck at 08:02 local time (01:02 BST), the USGS said.
It was felt 115km (71 miles) away in the provincial capital, Chengdu, according to China's state news agency Xinhua.
It said only 10 people had been confirmed dead, but other state media suggested the toll could be far higher.
"The earthquake in Ya'an, Lushan, has injured or killed hundreds of people," the Sichuan earthquake bureau said, quoted by an official website.
A resident in Chengdu told Xinhua he had been on the 13th floor of a building when he felt the quake.
The building shook for about 20 seconds and he saw tiles fall from nearby buildings.
The USGS noted that "significant" casualties were likely and that "extensive damage is probable and disaster is likely widespread".
"Past events with this alert level have required a national or international level response," it added, quoted by AFP news agency.
Magnitude Earthquake in Sichuan China On 20th April 2013
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