Jayalalithaa Jayaram, the chief minister of south India's Tamil Nadu state and one of the country's most popular political leaders, has died after a prolonged illness, hospital authorities announced late Monday night.
"It is with indescribable grief, we announce the sad demise of our esteemed honourable chief minister of Tamil Nadu ... at 11:30pm (local time) today (December 5)," Chennai's Apollo Hospital said in a statement released to the media.
Doctors had been treating the 68-year-old former film star, who enjoys an almost god-like status in Tamil Nadu.
Hundreds of devotees have kept a round-the-clock vigil outside the private hospital in the state capital Chennai since she was first admitted in September suffering from a fever. Their numbers have swelled since her condition worsened on Sunday.
Prime Minister Narendra Modi offered his condolences.
"I will always cherish the innumerable occasions when I had the opportunity to interact with Jayalalithaa ji (honorific). May her soul rest in peace," Modi said on Twitter.
Her political party, AIADMK, on Twitter said: "our beloved leader, the Iron lady of India... Amma, is no more."
To millions of her followers, the chief minister was known simply as "Amma" (mother).
The party also announced that her body would be kept at a prominent public hall in the city for people to pay their last respects.
The southern state had been tense since Sunday after reports that her health had worsened and she had been put on life support.
Earlier on Monday, scuffles broke out outside the hospital as many from the thousands of her supporters who had gathered outside tried to break through the police barricades.
Images on Indian news channels from across Chennai showed many men and women crying after her death was finally confirmed.
The police and security presence had been beefed up across the state over fears of chaos from the chief minister's angry and emotional followers.
Jayalalithaa had earned the loyalty of many voters in the state with a series of highly populist schemes, including "Amma canteens" that provided lunch for just three rupees (five cents).
She was also one of the country's most polarising politicians, accused of being dictatorial and was even jailed for corruption.
Several of her supporters resorted to self-harm when she was briefly jailed in 2014 on charges of corruption.
Her conviction, later overturned on appeal, sparked mass protests and even some reported suicides.
Thousands of directors, actors and producers in the successful Tamil language film industry went on hunger strike to demand her release.
Jayalalithaa's death has also plunged one of India's most economically powerful states into a period of political uncertainty.
Her trusted cabinet aide, O Panneerselvam, was sworn-in as the chief minister of the state after midnight.
Panneerselvam has been a lifelong loyalist of Jayalalithaa and she had earlier given him charge of the state when she had to step down over corruption charges.
Observers now worry whether a loyalist, without real charisma or mass support, will be able to rule smoothly in the absence of the firebrand leader.
After midnight, thousands of people lined both sides of the roads in Chennai trying to catch a glimpse of the late leader as her body was taken from the hospital to her residence in another part of the city.
Images on local news channels showed police struggling to maintain order with the crowds swelling, particularly around her residence.