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Russia has denied any role in the devastating bombing of Syria's opposition territories in Eastern Ghouta, which has killed close to 300 civilians in just a few days.

Moscow is one of the key backers of Bashar al-Assad's Syrian regime and has provided air support to government troops and allied militias since it entered the war in September 2015.

It has also been accused of killing thousands of civilians in air strikes, as well as causing the deliberate destruction of hospitals, schools, homes and markets.

But Russia Wednesday denied any involvement in the current brutal assault on Eastern Ghouta, echoing continued claims that it does not target civilian areas.

"These are groundless accusations. It is not clear what they are based on. No specific data has been given. We do not agree (with them)," said presidential spokesman Dmitry Peskov.

But images from Ghouta have shown Su-34 jets, which are operated by the Russian air force, in the skies overhead the besieged Damascus suburb.

The photos also appear to show the renowned "star" insignia of Moscow's air fleet on the wings of the aircraft.

Russia is known to operate the Su-34 bombers from its airbase in Latakia and they have played a key role in other large-scale bombings in Syria.

A US briefing has said that Russia is playing a key role in the killings.

The Syrian Observatory for Human Rights has also said Russia is involved in the air strikes.

At least 106 civilians - including 19 children - were killed in bombing in Eastern Ghouta on Tuesday, the Observatory said.

It was the second straight day that the civilian death toll topped 100, after 127 were killed Monday in Eastern Ghouta's bloodiest day in four years.

A key hospital has been put out of action and five other medical facilities damaged or destroyed in shelling and bombing.

Doctors have also been hindered by a lack of medical facilities due to a government siege on the territories.

Eastern Ghouta is covered by the Russian-Turkish-Iranian sponsored "de-escalation" zones deal, which was supposed to give civilians in the territories some respite from bombing.

The huge bombardment has led many to believe the Syrian regime is preparing for an assault on opposition-held Eastern Ghouta.

Russia played a key role in the bombing of East Aleppo in 2016, which coincided with a ground assault from regime and Iranian-backed militia forces.

A last-minute evacuation deal led to civilians and fighters leaving the territories but not before hundreds of civilians trapped in the former rebel bastion.

Human rights groups condemned the deal as an act of ethnic cleansing by the Syrian regime.

On Monday, Russia said it envisaged a similar deal between the Assad regime and opposition forces in Eastern Ghouta.

"The Aleppo experience - when the evacuation of fighters was organised - is completely applicable to Eastern Ghouta," Foreign Minister Sergei Lavrov said. 

Agencies contributed to this story.