City Hall officials said on Tuesday that four people have been killed. At least 95 people were hospitalized, of whom 50 are in grave condition, Itar-TASS said quoting Moscow's health department chief, Georgy Golukhov.
About 20 people remain trapped in one of the train carriages, RIA Novosti news agency said.
Several cars left the track in the tunnel during rush hour after a power surge triggered an alarm, which caused the train to stop abruptly.
"There was smoke and we were trapped inside," the man said. "It's a miracle we got out. I thought it was the end."
According to reports, one of the cars derailed about 200 metres from one of the metro stations. Several images posted on social media sites showed injured commuters being carried by rescuers in stretchers.
While accidents are regular occurrences in the Moscow Metro, deadly incidents are rare.
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