Hundreds have also been left injured, local officials told the BBC.
The earthquake struck near Mazar-e-Sharif, one of the country's largest cities that is home to about 500,000 people, at around 01:00 local time on Monday, (20:30 GMT on Sunday).
It had a magnitude of 6.3 and a depth of 28km (17 miles), according to the US Geological Survey, and was marked at the orange alert level, which indicates "significant casualties" are likely.
More than 530 people have been injured, according to the Taliban government health ministry.
Provincial officials earlier told the BBC that casualties were likely to rise as rescue efforts continued.
Haji Zaid, a Taliban spokesman in Balkh province wrote earlier on X that "many people are injured" in the Sholgara district, south of Mazar-e- Sharif.
He said they had received "reports of minor injuries and superficial damages from all districts of the province".
"Most of the injuries were caused by people falling from tall buildings," he wrote.
Many of Mazar-e Sharif's residents rushed to the streets when the quake struck, as they feared their houses would collapse, AFP news agency reported.
The quake led to a power outage across the country including in the capital city Kabul, after electricity lines from Uzbekistan and Tajikistan - major suppliers of power to Afghanistan - were damaged.
The Taliban spokesman in Balkh also posted a video on X appearing to show debris strewn across the ground at the Blue Mosque in Mazar-e-Sharif, revered by Shia Muslims.
