More than 200 bodies passed through Shohadaye Ashayer Hospital during the crackdown, according to an Iran International investigation based on more than two dozen sources, including medical personnel, eyewitnesses and people close to victims' families, as well as hospital records and videos obtained from inside the facility.
One eyewitness said at least 70 critically wounded protesters who could have been saved were transferred to the morgue instead of receiving further treatment.
Others were removed from treatment wards by security personnel before later reappearing in the morgue with fresh gunshot wounds to the upper body or what staff described as "finishing shots."
Iran International has so far verified the identities of 23 people killed in the city.
Hospital under siege
According to a member of the hospital's medical staff, Shohadaye Ashayer became the only hospital authorized to treat people wounded during the crackdown.
Armed security forces surrounded the hospital while police, intelligence officers and other security personnel operated inside the building. Officers stood over doctors and nurses as they treated patients, confiscated staff mobile phones and prevented them from contacting their families.
Hospital staff were effectively confined inside the facility for three days, the medical worker said. Several employees were arrested, while security forces moved through treatment wards identifying wounded protesters for detention.
Videos obtained by Iran International show dozens of bloodied bodies, many naked or partially unclothed, lying uncovered across the morgue floor and an adjoining room.
Some still had oxygen tubes in their mouths and electrocardiogram pads attached, suggesting they had been receiving treatment before being moved.
Several appeared to have been shot directly in the forehead, while others were covered with pellet wounds. Some had suffered catastrophic head injuries, with parts of their skulls missing. Several bodies also showed severe injuries to the genital area.
Some remained handcuffed despite bearing fatal gunshot wounds.
From operating room to morgue
Eyewitnesses described the hospital as overwhelmed, with blood covering corridors and bodies filling both the courtyard and the morgue. Multiple witnesses estimated that between 200 and 250 bodies passed through the hospital during the crackdown.
A student at Khorramabad University of Medical Sciences who witnessed patients arriving at the hospital described a similar pattern.
According to the student, wounded protesters repeatedly arrived alive on January 8 and 9, only for their deaths to be announced around 20 minutes after they had been taken into operating rooms. The student said the pattern was repeated across numerous patients.
The student also recalled a protester admitted on January 22 with extensive pellet wounds and a severe infection. Before treatment could be completed, security forces removed the patient from the hospital despite objections from the attending physician and took them to an unknown location.
Crackdown beyond the hospital
Witnesses said protests spread across much of Khorramabad on January 8 and 9, drawing tens of thousands of people into the streets.
They described security forces firing military-grade weapons, sniper rifles, shotguns and pellet guns at demonstrators, with several witnesses saying protesters were deliberately shot in the head and chest.
One witness said they personally saw at least five people killed after being struck from behind by bursts of gunfire.
Witnesses said security forces prevented many wounded protesters from reaching medical care, leaving some to bleed to death in the streets. Those who managed to reach Shohadaye Ashayer Hospital remained at risk of arrest, abduction or forced removal.
Witnesses also described an internet shutdown, movement restrictions and the widespread deployment of plainclothes officers, the Basij, the Revolutionary Guards and police units throughout the city.
Families under pressure
Eyewitnesses said bodies accumulated in the courtyard of Shohadaye Ashayer Hospital on January 9 while Basij forces prevented relatives from approaching them.
Some families removed the bodies of loved ones immediately, fearing security forces would seize them.
Among the victims whose identities Iran International has verified was Hossein Yaghmaei, who died after being shot and taken to a nearby home.
Retired municipal employee Hojjat Ahmadian was also among those killed. People familiar with his case said authorities pressured his family to record his death as suicide to avoid losing his pension.