Local activists said the RSF struck the Dar al-Arqam refugee camp with two drone attacks and eight artillery shells, which the RSF has denied, the BBC reported.
"Children, women and the elderly were killed in cold blood, and many were completely burned," members of an el-Fasher resistance committee said in a prepared statement on Saturday.
The strikes killed at least 14 children and 15 women in the besieged city that is located in North Darfur in western Sudan.
Another 21 people, including five children, also were injured, according to the Sudan Doctors' Network.
The SDN called the attack a "massacre" and blamed the RSF, despite the paramilitary unit's denial.
The attack struck the al Arqam Home that shelters displaced families in el-Fasher, Sky News reported.
The city has been under siege from paramilitary forces and caught in the middle of fighting between Sudan's military forces and paramilitaries operating in the region.
The RSF is among those paramilitaries and is trying to establish a separatist government in the North Dafur region.
El-Fasher is the last stronghold held by Sudan's army in the Darfur area and has been surrounded by the RSF for 17 months.
The RSF controls most of the Darfur region and much of the Kordofan province in central Sudan.
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