Two people are in Christchurch Hospital with serious injuries, while another 44 were treated at the emergency department and discharged, a spokesperson for the Canterbury District Health Board said.
Power has been cut to thousands of households and some are without water, roads and bridges have been damaged, and there is flooding and more liquefaction.
The strongest quake, measuring 6.0 at 2.20pm, was felt widely in the region and occurred 10km southeast of Christchurch at a depth of 9km.
The tremors began at 7.37am and continued throughout the day, including a short, sharp 5.5-magnitude jolt at 1pm, which was felt in other parts of the South Island from Hokitika to Dunedin.
Canterbury has been hit by strong earthquakes since 4 September last year when a magnitude 7 quake occurred, followed by the 6.3 quake on 22 February which killed 181 people and caused severe damage to central Christchurch.
Some buildings already damaged in the February quake and due for demolition collapsed on Monday.
Canterbury Earthquake Recovery Authority demolition manager Warwick Isaacs estimates that up to 50 city centre buildings were damaged or have collapsed.
Christchurch Cathedral suffered further damage, while the tower of the historic Timeball Station in Lyttelton has collapsed.
The quake caused extensive damage in the hill suburbs of Sumner and Redcliffs, bringing down large boulders and forcing people to leave their homes.
An extra 140 police remain in Christchurch from throughout the country following the February quake and will patrol the city and provide information to welfare services.
Police have warned people not to try and take advantage of the quakes to commit crime in the central city, as judges are taking these matters very seriously.
The Fire Service has stood down Urban Search and Rescue Teams but expected a number of callouts for assistance with liquefaction, flooding, burst pipes and possible gas leaks.
Schools and early childhood centres have been strongly advised by the Ministry of Education to stay closed on Tuesday.
Christchurch mayor Bob Parker concedes the latest tremors may be enough for more residents to join those who have already relocated to other cities in New Zealand and Australia.
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