A spokesman for the Saudi-led coalition, which is fighting Houthi rebels in Yemen, said it was targeting rebel missile launchers.
That was the toll at just one hospital.
Abdul-Ghani Nayeb, a local health official in Saada, told the Reuters news agency that at least 43 people were killed and 61 others left wounded by the strike.
The Saudi government issued a statement on August 9 and described the strike as "a legitimate military action" and was "conducted in conformity with the worldwide humanitarian law".
Medics treat a Yemeni child who was injured in an airstrike at an emergency clinic in the Iran-backed Houthi rebels' stronghold province of Saada, Aug. 8, 2018.
Wednesday's attack brings the tally to 165 rebel missiles launched since 2015, according to the coalition, which that year intervened in the Yemeni government's fight against Houthi rebels. Errant strikes have killed hundreds of civilians at hospitals, schools and markets.
"Scores killed, even more injured, most under the age of 10", Johannes Bruwer, head of delegation for the ICRC in Yemen, said in a Twitter post. "I am extremely saddened by what happened in Saada".
The ICRC said in its tweet: "Under global humanitarian law, civilians must be protected during conflict".
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The military alliance says it does not target civilians and has set up an investigation committee into alleged mass casualty air strikes which have mostly cleared the coalition of any blame.
"(The air strikes) conformed to worldwide and humanitarian laws", the coalition statement said, quoting spokesman Colonel Turki al-Malki.
Col Al Malki said the coalition struck back on Thursday at the Houthis responsible for the attack on Jazan. "We closely coordinate with them", spokeswoman Heather Nauert said. The simultaneous power vacuum and crippling of Yemen's already-weak health and security infrastructures have enabled al Qaeda and ISIS affiliates to operate, albeit under threat of USA airstrike, and unleashed a tsunami of starvation and disease.
The spokesman of the coalition backing the legitimate Yemeni national army said that "the targeting that took place today in the governorate of Saada, is a legitimate military action to target elements that planned and carried out attacks targeting civilians yesterday evening in Jizan that killed and wounded civilians". It was not immediately clear if there were any casualties in those strikes.
The Houthis have fired dozens of missiles into the kingdom in recent months, part of a three-year-old conflict widely seen as a proxy battle between regional rivals Saudi Arabia and Iran.
"Our support to the coalition consists of aerial refueling and intelligence support to assist our partners in securing their borders from cross-border attacks from the Houthis".
So far, almost 10,000 people have died in the war in Yemen, which has unleashed what the United Nations describes as the world's worst humanitarian crisis.
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