Human Rights Watch says government-controlled health services in Egypt have been pressured into playing down the number of casualties during anti-government protests.
The group has documented the deaths of 297 people, but says the final toll is likely to be significantly higher.
Human Rights Watch says the vast majority of the deaths in Cairo, Alexandria and Suez were on January 28 and 29 as a result of live gunfire as riot police fought running battles with protesters.
A significant proportion came as a result of rubber bullets fired at too close a range and from teargas canisters fired into the crowds at very close range.
Human Rights Watch says the actual number of deaths is likely to be an underestimate because the organisation had only included those deaths it had verified itself at key hospitals in the three major cities.
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