The bomb, hidden inside a sewage tanker, detonated close to the presidential palace and a number of foreign embassies, but in what has become a woefully familiar pattern ordinary civilians bore the brunt of the carnage.
A young Afghan man sobbed quietly outside Kabul's Emergency Hospital as he struggled to locate his uncle and cousins.
"They were going to their work like any other day and now they are lost," he told AFP.
"I have searched in three hospitals and haven't found them. I don't know where else to look."
Some more fortunate wept and hugged blood-stained relatives after tracing them inside.
Others gathered anxiously around medical staff as they read out names of the victims. Some of the mutilated bodies, the staff announced, were unrecognisable. But many teary relatives still insisted on sifting through them for identification.
As the wounded poured into hospitals, mainly of them critical, the interior ministry issued urgent appeals for blood, drawing dozens of volunteers from across Kabul.
"My two sons are severely wounded. I saw them, they are bleeding, they are dying," said a woman, breaking down into tears.
"I can't live without them. I will die without them."
The Emergency Hospital also sustained damage, but tweeted that its staff were nevertheless treating scores of wounded patients.
The nearby Wazir Akbar Khan hospital was packed beyond capacity, with doctors forced to treat two patients on one bed, many of them critically wounded by shrapnel and shards of glass.
President Ashraf Ghani slammed the attack as a "war crime", as health officials warned that the toll could rise still further.
"Today's bombing in a crowded area of central Kabul was yet another reminder of how deadly the war has become for ordinary Afghan civilians," said Patricia Gossman, a researcher with Human Rights Watch.
"Civilian casualties have reached record levels as the Afghan conflict has intensified this past year. Attacks of this kind that deliberately or indiscriminately target civilians are war crimes."
Two Afghan media workers were among those killed in the bombing, which also caused extensive damage to 1TV, a private news channel located close to the bombing site.
But in an act of defiance, the news channel managed to resume operations within a few hours.
"We are live and on air again," tweeted 1TV's editor-in-chief Abdullah Khenjani.
"Terror can't stop us."
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