According to a report by Human Rights Watch (HRW), evidence suggests that a misfired rocket was the probable cause of the explosion that led to numerous casualties at Al-Ahli Hospital in Gaza on October 17. The blast at the hospital ignited widespread outrage throughout the Arab world, with Palestinians accusing Israel of an airstrike and Israel claiming that it was caused by a Palestinian rocket misfire.

The health ministry in Gaza reported that 471 people were killed in the incident, a figure disputed by Israel. An unclassified US intelligence report estimated the death toll to be at the lower end of the spectrum, between 100 and 300. HRW's investigation into the explosion was based on a thorough review of photos and videos, satellite images, and interviews with witnesses and experts. They concluded that the explosion was likely caused by a rocket-propelled munition, commonly used by Palestinian armed groups. The incident at Al-Ahli Hospital was one of the most highly contested events in a war marred by accusations of disinformation and war crimes from both sides.

A senior Hamas official, Basem Naim, criticized HRW's report, claiming that it was biased towards Israel and lacked conclusive evidence. HRW has faced accusations of not providing supporting evidence or eyewitness testimony from Hamas, who had initially been asked to delay the report until after the war. Emmanuel Nahshon, deputy director general of public diplomacy at Israel's Ministry of Foreign Affairs, criticized the length of time it took HRW to release their findings. He expressed frustration at the delay and compared it to the swift conclusions reached by the rest of the world.

Naim, on the other hand, stated that Hamas would fully cooperate with HRW or any other international investigative body if they were willing to visit Gaza and conduct an in-depth investigation. HRW also highlighted the unusually high kill-to-injury ratio of 471 dead and 342 injured in the reports, which appeared disproportionate to the visible damage at the hospital. They urged authorities in Gaza and Israel to release any evidence they had regarding the Al-Ahli hospital explosion to allow for a comprehensive investigation.

Throughout the Israel-Hamas conflict, hospitals have been targeted, and normal functioning in the northern part of Gaza has been severely disrupted. While some patients who could not evacuate and displaced individuals continue to seek refuge in these hospitals, the attacks have destabilized healthcare services. Palestinians have accused Israel of intentionally targeting hospitals and schools, while Israel argues that Hamas uses civilians as human shields by placing military positions in civilian buildings.