At this stage, it is still unclear what caused the trains to crash, but the regional governor says the two services were running on the same track.
A local station master, based at Larissa, has been arrested. He has been charged with manslaughter by negligence and grievous bodily harm by negligence, but denies any wrongdoing.
Rail unions say there have been long running problems with electronic systems that are supposed to warn drivers of danger ahead.
One survivor told Reuters "we heard a big bang", adding: "For 10,15 seconds it was chaos."
Stergios Minenis described the scene as: "Tumbling over, fires, cables hanging, broken windows, people screaming, people trapped."
Another survivor, Lazos, told the newspaper Protothema: "I wasn't hurt, but I was stained with blood from other people who were injured near me."