The US Geological Survey put the magnitude at 5.6 and said it was just 18km (11 miles) deep.
The tremors were felt as far away as Kathmandu and even about 600km (375 miles) away in the Indian capital New Delhi.
“The death toll has reached 119 and at least 100 have been injured,” Karnali Province police spokesman Gopal Chandra Bhattarai was quoted as saying by the AFP news agency.
Jajarkot local official Harish Chandra Sharma said at least 34 people had been killed in his district while in neighbouring Rukum West district, police official Namaraj Bhattarai said at least 35 deaths had been reported.
Media footage showed crumbled facades of brick houses, with large pieces of furniture scattered on the ground.
Local officials said it had not yet been possible to establish contact with areas near the epicentre in Ramidanda.
Nepal lies on a major geological fault line where the Indian tectonic plate pushes up into the Eurasian plate, forming the Himalayas, and earthquakes are a regular occurrence.In 2015, about 9,000 people were killed in two earthquakes in Nepal. Whole towns, centuries-old temples and other historic sites were reduced to rubble, with more than a million houses destroyed.