Survivors told harrowing stories of riding out winds of 190-198 mph in walk-in coolers in restaurants and convenience stores, hiding in bathtubs and closets, and of running for their lives as the tornado bore down.
"We were getting hit by rocks and I don't even know what hit me," said Leslie Swatosh, 22, who huddled on the floor of a liquor store with several others, holding onto each other and praying.
When the tornado passed, the store was destroyed but those inside were all alive.
"Everyone in that store was blessed. There was nothing of that store left," Swatosh said.
Roaring along a path nearly six miles long and about 1/2 mile to 3/4 mile wide, the tornado flattened whole neighborhoods, splintered trees and flipped over cars and trucks. Some 2,000 homes and many other businesses, schools and other buildings were destroyed.
At St John's hospital 180 patients cowered as the fierce winds blew out windows and pulled off the roof. According to AccuWeather.com Senior Meteorologist Alan Reppert, X-ray films from the hospital were found 70 miles away.
20 MINUTES NOTICE
The city's residents were given about 20 minutes' notice when 25 warning sirens sounded in the evening, said Jasper County Emergency Management Director Keith Stammers.
Nixon said many people may have been unable to get to shelter in time. "The bottom line was the storm was so loud you probably couldn't hear the sirens going off." He declared a state of emergency and called out the National Guard to help.
An estimated 20,000 homes and businesses were without power in Joplin. To help with communications Verizon Wireless, a unit of Verizon Communications Inc, said it was delivering three temporary cell towers for emergency service.
The Joplin tornado was the latest in a string of powerful twisters that has wreaked death and devastation across many states, and it comes as much of the Mississippi River valley is underwater from massive flooding.
Twisters killed more than 300 people and did more than $2 billion in damage across southern states last month, killing more than 200 in Alabama alone.
The death toll of at least 116 topped the 115 people who died in a 1953 tornado in Flint, Michigan. A 1947 tornado in Woodland, Oklahoma, killed 181 people.
Joplin City Councilwoman Melodee Colbert-Kean, who serves as vice mayor, said the town was in a state of "chaos."
"It is just utter devastation anywhere you look to the south and the east -- businesses, apartment complexes, houses, cars, trees, schools, you name it, it is leveled, leveled," Councilwoman Melodee Colbert-Kean said.