[35] In October, the government restricted the use of the al-Wafideen crossing, an entry point for merchandise, which led to food and medical supply shortages within Ghouta.

[36] According to the UN and Human Rights Watch, in late October and November 2017, hostilities intensified, with frequent reports of shelling on several densely populated areas of eastern Ghouta.

[42] The rebel forces, led by Ahrar al-Sham, also launched an assault against Syrian Army positions in the Police Housing area of the Harasta suburb.

According to pro-government sources, the points were recaptured by the army in the evening amid airstrikes on rebel positions conducted by the Russian Air Force.

[4][44] In retaliatory attacks, aerial strikes and shelling hit Harasta, Irbin, Mesraba, Hamouriyah, and Saqba towns in Eastern Ghouta with at least eight civilians killed and about 94 wounded in the first 20 hours.

[45] In retaliation for the Ahrar al-Sham attack, the government conducted an aerial bombardment of rebel-held areas, according to an Agence France-Presse photographer and opposition sources.

[47] Government aircraft were reported to have bombed a crowded public market in Misraba, 1.5 km (0.93 mi) to the east, as part of its counterattack on rebel positions, killing at least 16 civilians.

[48] From 14 to 30 November, the Russian-Syrian joint military operation conducted over 400 airstrikes on eastern Ghouta, according to Civil Defense,[36] and SOHR reported that at least 127 people, including 30 children, had been killed by air strikes and shelling in the offensive by the end of the month.

[49] On 6 December, the World Health Organization reported nearly 500 sick and wounded patients still await medical evacuation from eastern Ghouta, which the Syrian government had not granted.

[54][additional citation(s) needed] Later in the day, Ahrar al-Sham, HTS and Al-Rahman Legion seized over 50 buildings to the west of the base and besieged it, cutting off all supply lines.

[31][59] That day, a primary health care center in Harasta was impacted by an airstrike, resulting in minor structural damage, according to aid organisations.

[65] On 3 January, the Syrian Army and Russian Air Force escalated bombing of rebel-held areas with the intention of relieving the 200 troops trapped in the base.

[71] On 5 January, the Syrian army reportedly recaptured the Basher Hospital from the rebels as part of a renewed push in Harasta district and were within 100 metres (330 ft) of the military vehicle depot base from the western direction.

[73] On 7 January, pro-government sources reported that the 4th Armoured Division captured a mill to the west of the base, enabling them to announce that they had broken the siege.

[77] On 9 January, airstrikes on residential areas of eastern Ghouta continued, with reports of 24 deaths, including 10 children, and at least 13 civilians killed in opposition-controlled Hamourya.

[82] It was reported that Syrian government forces fired three surface-to-surface missiles filled with poisonous chlorine gas between the cities of Harasta and Douma on 13 January.

[98][99] Ground fighting continued into the following week, with Al-Masdar reporting on 14 February that SAA and rebel fighters had "traded offensives" in the suburb, causing "some of the fiercest firefights" of 2018.

Government ground troops advanced, with Syrian state TV claiming to have captured several buildings in Harasta,[105] and Civil Defence reporting air and artillery attacks.

[106] On 26 February, Syrian state TV broadcast live footage showing Harasta being pounded by airstrikes and artillery, saying the target was HTS fighters.