[12] A week after the incident, several sources considered that an errant rocket from Gaza was the likeliest explanation, based on the evidence gathered in investigations conducted by the Associated Press, CNN, The Economist, The Guardian, and The Wall Street Journal.

[11] Investigations by Channel 4 News,[14] Al Jazeera,[15] and research groups Earshot[16][17] and Forensic Architecture (FA) contested Israeli claims of a misfired Hamas rocket being responsible for the blast.

[11] On Saturday 14 October, according to a statement by the Archbishop of Canterbury, Justin Welby, an Israeli rocket had damaged the upper two floors of the hospital's cancer treatment center, which contained the ultrasound and mammography wards, and injured four staff members.

[37] The Human Rights Watch report published on 26 November 2023 noted that the damage resulting from the 14 October incident appeared kinetic and not explosive, and that an illumination flare was visible in social media posts depicting the event.

[42] In his statement on Sunday 15 October 2023 Archbishop of Canterbury, Justin Welby said, "The seriously ill and injured patients at the Anglican-run Ahli Hospital – and other healthcare facilities in northern Gaza – cannot be safely evacuated.

[4][7] Early efforts to analyse the Al-Ahli Arab Hospital explosion were quickly complicated by a variety of claims and counterclaims over who was responsible, as well as the rapid spread of unverified, misleading and false information on social media.

[10] Human Rights Watch stated that the numbers put out by the Gaza Health Ministry, if true, would represent an unusually high death-to-injury ratio (471 killed vs. 342 injured) and would appear out of proportion with the damage observed at the explosion site.

[31] The explosion resulted in massive protests in the West Bank, Iran, Canada, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Qatar, Syria, Tunisia, Turkey, the United Kingdom, and Yemen.

"[69][70] BBC also issued a clarification and apology on 23 October, writing: "We accept that even in this fast-moving situation it was wrong to speculate in this way about the possible causes and we apologise for this, although he did not at any point report that it was an Israeli strike.

"[75][73] On 25 October 2023, Le Monde published an explanation stating that they "were not cautious enough" in their initial coverage, which suggested that the Israeli army was responsible for the explosion and was not explicit in disclosing that the health ministry in the Gaza Strip is "administered by Hamas."

[47][82] In a 26 November report, Human Rights Watch reached the same conclusion as The New York Times, The Washington Post, and Le Monde, namely, that the projectile shown in the Al Jazeera live stream video appears to be an Iron Dome missile intercepting a rocket over Israeli territory at a location that is too far away from the hospital to have caused the explosion.

[85][86] The Wall Street Journal reported that analysts who examined publicly available images said the explosion site did not "bear the hallmarks of a strike with a bomb or missile of the types used by Israel" and that the "damage appeared more consistent with a fireball from a rocket".

[82] Der Spiegel reported that the opinion of Fabian Hoffman, a weapons researcher at the University of Oslo, is that the most likely explanation regarding the cause of the explosion is that a rocket fell apart in several phases and hit the hospital.

[51] In a follow-up report on 2 November 2023, CNN concluded that the Al Jazeera broadcast showed a projectile that was likely fired from Israel and had no connection to the explosion, reiterating that "[u]ntil an independent investigation is allowed on the ground and evidence is collected from the site, the prospect of determining who was behind the blast is remote".

[11] In its February 2024 investigation, Forensic Architecture noted that "Multiple news outlets cited Israeli military spokesperson Daniel Hagari's claim that it was a Palestinian rocket that struck al-Ahli hospital with 'most of this damage... done due to the propellant, not just the warhead'.

However, their analysis revealed that this was not possible, for it "suggests that all seventeen visible rockets in the salvo the Israeli military claimed was responsible had finished burning their fuel mid-flight, meaning that by Hagari's own logic they could not have caused the damage to al-Ahli.

[103] Voice of America and NBC News quote a US intelligence official who said that their conclusions regarding the cause of the explosion were based in part on another audio recording, different from the publicly available one and assessed as authentic by language experts.

[106][40] Rear Admiral Daniel Hagari of the IDF Spokesperson's Unit said that intelligence indicated that PIJ had launched a barrage of rockets near the hospital, and shared drone-collected aerial photography that he said was inconsistent with Israeli munitions.

[82] David Leonhardt of The New York Times wrote on 20 October that "Gaza officials and their supporters have three main arguments, all circumstantial":[115] Hamas failed to produce or describe any evidence linking Israel to the explosion.

[121] US president Joe Biden supported the Israeli account of events, and referred to Pentagon intelligence sources that indicate the explosion was caused by a Palestinian Islamic Jihad (PIJ) rocket misfire.

[125] The New York Times reported that Palestinian communications intercepted by Israel and publicly available video gave the intelligence community high confidence that a rocket launched from Gaza experienced a "catastrophic motor failure," causing the warhead to fall near the hospital.

The officials also told the Times that they had authenticated communications intercepts provided by Israeli intelligence, all of which consisted of Hamas members "discussing their belief that the explosion was caused by an errant or malfunctioning rocket fired by Palestinian Islamic Jihad."

[130] Rishi Sunak, the UK Prime Minister, told the House of Commons that, relying on British intelligence agencies, the government had concluded that the blast was likely the result of a Palestinian rocket fired towards Israel.

[61] Dmitry Medvedev, the Deputy Chairman of the Russian Security Council, condemned the explosion on the messaging app Telegram as a "blatant act of war," and placed the blame on the United States for this tragic incident.

Dmitry Polyanskiy, the country's deputy envoy to the UN, mentioned on Twitter that Russia, along with the United Arab Emirates and China, has suggested the inclusion of a condemnation of the blast in a resolution drafted by Brazil, which calls for a "humanitarian pause" in the Israel-Hamas conflict.

As the prime minister prepares to address the Israel-Hamas conflict during an inaugural summit between Southeast Asian and Gulf states, he has previously resisted pressure to denounce Hamas, affirming Malaysia's commitment to maintaining its relationship with the Islamist group.

[141] In a recent statement shared on Twitter, Syrian president Bashar al-Assad expressed his deep condemnation of the hospital attack, describing it as an abhorrent and extremely brutal act that stands as one of the most atrocious and bloodiest massacres in modern history.

However, due to the current insecurity, critical condition of patients, lack of ambulances, staff, health system bed capacity, and alternative shelter for the displaced, carrying out these orders was deemed impossible.

[153] Saudi Arabia, Jordan, Qatar, UAE, Bahrain, Oman, Egypt, Lebanon, Pakistan, Algeria and Libya condemned the explosions as attacks, and accused Israeli forces of bombing the hospital.

[160] On 26 November 2023, Human Rights Watch published a report finding that the cause of the explosion was likely a misfired Palestinian rocket, but that the victims and their families deserved full answers concerning the circumstances, including the identity of those responsible for launching or authorizing the attack–something that only a thorough investigation and analysis of all evidence could provide.