With Italian media focusing on the antiquated technology on the single-track line, prosecutors have opened an investigation and Prime Minister Matteo Renzi has promised that the cause of Tuesday's accident will be quickly identified.
Rescuers were still searching for the driver of one of the trains that collided head-on while traveling down the same stretch of track linking the small towns of Corato and Andria in the southeastern Puglia region in Italy's heel.
The driver of the other train was one of the victims. With dozens of people injured, some seriously, rescuers expected the death toll could rise higher.
It is still unclear whether the accident was due to human error or a technical problem on a stretch of track where safety is dependent on telephone calls rather than computer systems.
While Italy boasts efficient high-speed train links between its main cities of Naples, Rome, Milan and Turin, much of the country is still dependent on slow, outdated and dilapidated services, especially in the undeveloped south.