Competitors and race volunteers were crying as they fled the chaos. Authorities went onto the course to carry away the injured while race stragglers were rerouted away from the smoking site.
Roupen Bastajian, a 35-year-old state trooper from Smithfield, R.I., had just finished the race when they put the heat blanket wrap on him and he heard the blasts.
"I started running toward the blast. And there were people all over the floor," he said. "We started grabbing tourniquets and started tying legs. A lot of people amputated. ... At least 25 to 30 people have at least one leg missing, or an ankle missing, or two legs missing."
At Massachusetts General Hospital, said Alisdair Conn, chief of emergency services, said: "This is something I've never seen in my 25 years here ... this amount of carnage in the civilian population. This is what we expect from war."
The Boston Marathon honored the victims of the Newtown, Conn., shooting with a special mile marker in Monday's race.
Boston Athletic Association president Joanne Flaminio previously said there was "special significance" to the fact that the race is 26.2 miles long and 26 people died at Sandy Hook Elementary school.