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At least 36 of the injured remained hospitalised, according to Joel Santos, minister of the presidency.
Local media reported that an additional 11 people are missing.
President Luis Abinader was expected to travel later Tuesday to the site, where authorities were still trying to extinguish a fire amid collapsed buildings and charred vehicles.
The country’s 911 system said the explosion occurred at a bakery in the city’s centre, a bustling area known as “Old Marketplace” where people buy goods ranging from vegetables to clothes. The fire then spread to a hardware store next door and a nearby furniture store.
Among the victims is a four-month-old baby who died from head trauma and a woman who worked at a bank, officials said.
Santos said the government is launching an investigation to determine whether the business where the explosion occurred was operating under the proper regulations.
It wasn’t clear what caused the explosion, and authorities have not provided a preliminary estimate of damages.
“Unfortunately, these catastrophes have an order of priority: save lives, save assets, ensure that the incident is extinguished and then assess damage,” Santos said at a press conference.
San Cristobal, the birthplace of dictator Rafael Trujillo, was the site of another explosion nearly 23 years ago. An arms depot exploded in October 2000, killing at least two people and injured more than two dozen others, forcing authorities to evacuate thousands.
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