The attacks came as Ukrainian President Volodymyr Zelensky arrived in the Netherlands to meet with allies on the sidelines of the NATO defence alliance summit.
He is expected to meet with US President Donald Trump on Wednesday to discuss more sanctions on Russia and arms procurement, a senior Ukrainian source told AFP.
Trump has struggled to deliver on his vow to quickly end the Ukraine war, now in its fourth year.
He clashed bitterly with Zelensky at the White House in February, which stunned Ukraine's Western allies.
Since then, Zelensky has been at pains to try to mend the relationship. The pair had a brief sit-down at the Vatican in April.
In the aftermath of Moscow's latest attack, emergency services in the industrial Dnipropetrovsk region, now threatened by Russian battlefield advances, published photos of rescuers helping civilians covered in blood.
"Putin destroys lives, that's how he defines control. If he can kill people, destroy homes, blackmail others, he believes he has power," Zelensky said on X.
Ukrainian Foreign Minister Andriy Sybiga said the strikes amounted to a "rejection of peace" from Russia, which has rebuffed US and Ukrainian ceasefire proposals.
"It is a matter of credibility for allies to step up pressure on Moscow," Sybiga said.
Dnipropetrovsk Governor Sergiy Lysak said 17 residents of the central city of Dnipro were killed and 279 people, including children, were wounded.
Two more were left dead in the nearby town of Samar.
Police said an administrative building, shops, educational facilities and a children's hospital were damaged.
- Toddler killed -
Russian forces recently claimed to have reached the border of the Dnipropetrovsk region, gaining a foothold there for the first time in the war.
The attacks on Dnipro city, the region's capital, came just hours after deadly overnight drone attacks.
Three people including a toddler were killed earlier in the northeastern Sumy region, which borders Russia, during the barrage, local officials said.
Oleg Grygorov, head of the Sumy region's military administration, said a five-year-old boy was pulled from the rubble of a destroyed house.
"The strike took the lives of people from different families. They all lived on the same street. They went to sleep in their homes but the Russian drones interrupted their sleep -- forever," he said.
On the Russian side, one man died next to his spouse in a Ukrainian drone strike on Russia's western border region of Belgorod, the governor said, adding that the woman survived the attack.
Another drone had targeted a residential building in Moscow overnight, wounding two people, including a pregnant woman, the local authorities said.
Russia occupies around a fifth of Ukraine and claims to have annexed four Ukrainian regions as its own since launching its invasion in February 2022 -- in addition to Crimea, which it captured in 2014.
Kyiv has accused Moscow of deliberately sabotaging peace talks to prolong its full-scale offensive and seize more territory.
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