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A Palestinian refugee camp in Syria risks being "another Yarmouk" after four people were killed - among them a one-year-old baby.

UNWRA, the UN relief agency for displaced Palestinians, has condemned the October 18 attack in which a car was shelled as it attempted to leave the besieged Khan al-Sheikh camp, south of the capital.

"We are deeply concerned about the situation of Palestine refugees in Khan al-Sheikh and the real risk of it becoming another Yarmouk, the refugee camp in Damascus devastated by years of fighting and terrifying violence," UNRWA spokesman Chris Gunness said.

"Camp residents face grave risks when attempting to leave Khan al-Sheikh," he added.

Nofeh Mohammed Jarad, who was in her 60s, her daughter Ibaa Saeed al-Nader, 22, their driver, and a one-year-old baby were killed in the attack.

The mother of the baby, a Syrian citizen, also died in the late-night incident.

The camp, home to about 8,000 Palestine refugees, has suffered intensified armed conflict since May, resulting in a rising number of civilian casualties and at least 31 deaths.

Earlier this month, two aid workers were killed by barrel bombs dropped on the area.

"Access to humanitarian assistance has been constrained since 2013 and UNRWA is particularly concerned about a lack of medicines and the impact this will have on children, chronic disease patients and the elderly," Gunness said.

"UNRWA calls on the parties to allow civilians, who wish to leave the area, to do so in safety."

At least 3,191 Palestinians have been killed in Syria since the beginning of the conflict in March 2011, including hundreds who have died making the perilous journey across sea to Europe.