A U.S. drone attack in Pakistan's North Waziristan killed 23 people including five children Friday.
The strike against militants came days after the Chairman of the Joint Chiefs of Staff, Admiral Mike Mullen, visited Islamabad and expressed concern over possible links between Pakistani security agents and militants.
A government official in North Waziristan told the New York Times the strike killed five children and four women.
The strike, which hit Mir Ali, a town about 20 miles east of Miranshah, targeted a home used as a militant hideout, a Pakistani intelligence officer told Reuters.
The incident comes amid increasing opposition within Pakistan to the drones, which have been used by the United States for years to target militants suspected of using the region as a base to attack American and NATO troops in Afghanistan.
The Pakistani government has also said the attacks and resulting civilian casualties have increased anti-U.S. sentiment and support for militancy.
The head of Pakistan's spy agency met with the head of the Central Intelligence Agency in Washington earlier this month to push for an end to the drone attacks, but the attack Friday shows United States has decided to continue the drones, the Times reports.
The attack in North Waziristan comes a day after the United States promised to supply Pakistan with non-lethal mini drones, the Times of India reports.
The United States also decided to use Predator drones in its offensive against Libya's Muammar Gaddafi.