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The Israeli military says it is carrying out a "precise and targeted operation against Hamas" in part of Al-Shifa Hospital "based on intelligence information and an operational necessity".
In a statement on social media, the Israeli Defense Forces (IDF) say their forces "include medical teams and Arabic speakers, who have undergone specified training to prepare for this complex and sensitive environment."
They say the intent is that "no harm is caused to the civilians being used by Hamas as human shields".
The IDF goes on to say that it had recently told Gazan authorities that all military activity within the hospital had to end but that it had not.
The BBC could not immediately verify the Israeli report.
Thousands of civilians including patients and medical staff are said to be sheltering in and around the hospital.
Hamas denies using the hospital for its operations and has called for an international committee to come in and inspect.
Earlier, the US said it had intelligence that Hamas had a command centre under the hospital.
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