The Syrian Observatory for Human Rights (SOHR) said on Saturday that suspected Russian air strikes hit central Douma, where several markets were targeted killing at least 23 people.
According to an officer from the Douma branch of the Syria Civil Defence department, within the past hour, at least 3 air strikes deliberately hit residential areas in the region .
"The air strikes are targeting the centre of Douma, including a market and residential street," he said.
"Not just air strikes - rockets are being launched into the city too. More than 21 people have been killed, including two children, and dozens of others have been injured.''
"The Syria Civil Defence members are at the scene now trying to rescue the civilians. The death toll is expected to rise," he told Al Jazeera over the phone.
The SOHR's director, Rami Abdel Rahman said that the toll could rise because there were several people who were seriously injured.
At least six children and seven women were among the dead, reported the SOHR.
Douma, located east of the Syrian capital, has been an opposition stronghold throughout the conflict which started four-and-a-half years ago in the context of the Arab Spring revolutions that swept the Middle East and North Africa.
On October 30, 70 civilians were killed by the Syrian regime warplanes which carried out attacks on a busy market in the Damascus suburb of Douma while at least 550 were wounded, said Doctors Without Borders (MFS).
An estimated 250,000 people have been killed in the ongoing war in Syria, with most casualties occurring due to barrel bombs dropped indiscriminately on civilian areas from regime helicopters.
All together, around 12 million Syrians, amounting to half of the country’s population, have been displaced from their homes.
While an estimated 6.7 million remain displaced internally, an estimated 5 million have fled to neighbouring countries including Turkey, Lebanon, Jordan and Egypt.
Many have dared to make the dangerous voyage across the Mediterranean from the departure point in Libya and Turkey’s western coast in a bid to enter European Union countries.
Around half a million refugees, mostly Syrians, have entered Europe this year, causing the worst refugee crisis experienced in Europe since World War II.