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The bombings took place within minutes of each other at around 1030 local time.
No-one has claimed responsibility but US officials suspect the attacks were the work of Osama bin Laden, an Islamic fundamentalist.
The first blast happened in the Tanzanian capital Dar es Salaam and the second, just five minutes later, in Nairobi, Kenya's capital city.
US ambassador hurt
The Nairobi explosion demolished a five-story office block sending it crashing onto the embassy next door.
The US Ambassador Prudence Bushnell was meeting Kenyan Trade Minister Joseph Kamotho at the nearby Ufundi Cooperative Bank at the time but was only slightly injured.
The blast could be heard 10 miles (16km) away and caused total chaos in the city centre.
Rufus Drabble, from the British High Commission, said there was a cloud of thick smoke over the city and helicopters hovered overhead.
The US embassy was extensively damaged and its bomb-proof doors were ripped off. Two passing buses were also wrecked.
Volunteers worked furiously to pull survivors from the rubble and cranes have been brought in to free people who are trapped at the bomb site.
There was also widespread devastation in Dar es Salaam, where a BBC correspondent said the embassy reception area had been destroyed.
Survivor Jim Owens said the blast at the Tanzanian embassy threw him back about five feet (1.5m).
He said: "The cuts I have do not look that bad but they bled profusely.
"They bled over my glasses so I couldn't see as I was walking around the smoke-filled embassy."
US President Bill Clinton has condemned the attacks as "abhorrent" and said every effort would be made to catch the bombers.
He said that the US was sending counter-terrorism experts and medical teams to the region. A team of US marines is also flying there to bolster security along with FBI agents.
"These acts of terrorist violence are abhorrent, they are inhuman," Mr Clinton said at the White House press conference.
"We will use all the means at our disposal to bring those responsible to justice," he added.
Mr Clinton said flags at all US government buildings would be flown at half-mast as a mark of respect to the victims.
The Kenyans were ill-equipped to deal with such a huge disaster.
It wasn't until an Israeli search and rescue team arrived that the last bodies were retrieved and the final death toll known - 207 Kenyans and 12 US citizens in Nairobi.
Another 11 lives were lost in the Tanzanian bombing. Altogether more than 4,000 people were injured.
Four men linked to al-Qaeda were convicted and jailed for life for the attacks in May 2001. They were Mohamed Rashed Daoud al-'Owhali, Khalfan Khamis Mohamed, Wadih al-Hage and Mohamed Sadeek Odeh.
A memorial park was opened in Nairobi on 7 August 2001 to commemorate the victims of the blast.
The US spent $4.3 million helping bomb victims and rebuilding central Nairobi but some survivors felt it was not enough. They tried and failed to sue the US Government for compensation.
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