The quake happened at 08:12 (00:12 GMT) on a national holiday. The US Geological Survey said it struck below the island of Bohol, where officials reported most casualties.
People were also killed in the province of Cebu.
Historic churches were among the many damaged buildings, and stampedes were reported in two cities.
At least 69 of those confirmed dead were from Bohol, according to reports citing disaster management officials.
Fifteen people are known to have been killed in Cebu, and another was reported dead on the neighbouring island of Siquijor.
Dozens of others are also being treated for injuries.
Search and rescue operations are being conducted, with rescuers finding themselves hampered by damaged roads.
At least five people died when part of a fishing port collapsed in Cebu, and two others were also reported dead when a roof fell at a market.
At least three people also died during a stampede at a sports complex in Cebu, provincial disaster chief Neil Sanchez said.
"There was panic when the quake happened and there was a rush toward the exit," he told AFP.
The tremor triggered power cuts in parts of Bohol, Cebu and neighbouring areas, say reports citing the country's disaster management agency.
Officials from Bohol and Cebu have declared a state of emergency in their respective provinces, local media say.
An official from the government agency which monitors earthquake activity was quoted as saying that this was the strongest tremor felt in the area in the last 23 years.
President Benigno Aquino is expected to visit the affected areas on Wednesday.