Israeli troops pull out of a major Gaza hospital after a two-week battle.

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Israeli soldiers withdrew from Al-Shifa Hospital in Gaza City after two weeks of fighting in which they killed around 200 Palestinians and arrested hundreds of others, the Israeli military said on Monday. The troops left widespread devastation in their wake after extended gun battles with Palestinian militants in and around the complex.

Taysir al-Tanna, a longtime vascular surgeon at Al-Shifa, said many of the hospital’s main buildings — including the emergency, obstetrics and surgical wards — had been badly damaged in the fighting, and the main gate had been smashed.

“Now it looks like a wasteland,” Dr. al-Tanna said.

Mahmoud Basal, a spokesman for the Palestinian Civil Defense, said bodies were scattered in and around the complex. The final death toll remained unclear, he said, as some corpses were either under the rubble of destroyed buildings or were believed to have been buried.

“Even outside the complex itself, there are blocks of buildings that were knocked to the ground,” and people were searching for the occupants in the rubble, Mr. Basal said.

The Israeli military said the roughly 200 Palestinians it killed were militants, and that its soldiers had arrested around 900 people it suspected of being militants at the Shifa complex over the past two weeks, including senior commanders in groups like Hamas and Palestinian Islamic Jihad. It said two Israeli soldiers were killed and eight were wounded in the raid.

Rear Adm. Daniel Hagari, the Israeli military spokesman, blamed the destruction on the militants, saying they had fortified themselves inside hospital wards, fired on soldiers and refused calls to surrender. “We had to fire on the buildings in order to stop that and to kill the terrorists,” he said.

Israeli forces evacuated displaced civilians sheltering in the compound as well as some patients, and placed other patients in a building away from the fighting, Admiral Hagari said. The World Health Organization said on Sunday that at least 21 patients had died since the Israeli raid began in mid-March, though their causes of death were unclear. By this weekend, just 107 patients remained — 30 of them bedridden — without drinking water and with only minimal medication, the Gaza Health Ministry said in a statement.

Israeli forces first raided Al-Shifa in November, maintaining that Hamas militants had built a command center in tunnels underneath it. Hamas and the hospital director insisted the facility was solely a refuge for civilians.

The Israeli military later publicized some evidence to support its case, including by showing reporters a fortified tunnel constructed underneath the hospital grounds. An investigation by The New York Times suggested that Hamas had used the site for cover and stored weapons there. Critics argue that Israel failed to substantiate its original claims about Al-Shifa’s military value.

After little more than a week, Israeli troops withdrew in compliance with a brief cease-fire. But as the war ground on, Israeli forces closed in on the hospital again in mid-March in an attempt to root out what they said was a renewed insurgency by Palestinian armed groups in northern Gaza.

“Hamas and Islamic Jihad have started to rebuild themselves in the north,” said Admiral Hagari. “And they re-based themselves inside Shifa.”

Hamas has not commented on the new allegations that it was using the hospital as a base, but in a statement it accused the Israeli military of summarily executing Palestinians inside. The group’s armed wing has repeatedly said that its militants were fighting with the Israeli military around Al-Shifa over the past two weeks.

Hamas called the destruction at the hospital “a horrific crime” that Israel had perpetrated “with full and unlimited support from the administration of U.S. President Biden.”

Before the first Israeli incursion, Israel gave the hospital more than a week’s notice ahead of its forces entering the complex, giving militants hiding there an opportunity to flee, Admiral Hagari said. This time, Israeli soldiers launched a surprise attack, raiding the area in the middle of the night, he added.

In a visit to Al-Shifa on Saturday, Herzi Halevi, the Israeli military chief of staff, declared the raid “extremely successful.” Lt. Gen. Halevi said the operation had let militant groups know that “a hospital is not a safe place” for them.

Asked about the destruction at Al-Shifa, Karine Jean-Pierre, the White House press secretary, said the Biden administration was concerned over Hamas’s repeated activity within hospitals, as well as “how Hamas appears, how they appear to have been able to reconstitute in a hospital so quickly.”

“This just points to how challenging Israel’s military operation is, because Hamas has intentionally embedded themselves into civilian infrastructure, into these hospitals,” Ms. Jean-Pierre told reporters.

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