Dozens are said to be missing, although there are unconfirmed reports that as many as 1,300 people are still unaccounted for in the Ahrweiler District of the Rhineland-Palatinate state. Many of those who have died were Germans, but Belgium also reported nine victims, including a 15-year-old girl. The worst hit areas are German states of Rhineland-Palatinate and North Rhine-Westphalia.
German authorities deployed police helicopters and hundreds of soldiers to help those stranded by the floods.
However, some areas have been completely cut-off and could no longer be reached by boat.
Climate change has been blamed for the extreme weather which caused the floods.
Armin Laschet, the premier of North Rhine-Westphalia, told reporters on Thursday: “We will be faced with such events over and over, and that means we need to speed up climate protection measures… because climate change isn’t confined to one state.”
More heavy rain is forecast across the region on Friday.
Many villages were reduced to rubble as old brick and timber houses were swept away by the rushing waters.
Belgian authorities ordered residents of Liège to evacuate their homes, as fears grew of further flooding.
The Meuse river is on the verge of bursting its banks and experts fear water levels could still rise by another 1.5 metres.
In the Netherlands, which has so far avoided any casualties, thousands of people living in towns and villages along the Meuse have also been ordered to abandon their properties.
Likewise, in Maastricht 10,000 residents were told to evacuate.