48 people were injured in the fire on the 5th floor of a 27 story apartment building at 225 East 149th Street in the Morrisania section.
Five people, including a child, remain in critical condition at Lincoln Hospital.
The fire spread heavy smoke throughout the building.
Firefighters went from apartment to apartment checking on residents who breathed in the smoke.
"It just started in the bedroom, I didn't know what else to do," said Samantha Covel.
Covel was in her apartment with two other adults and two children, when she was awakened by the intense smoke and flames.
Investigators say the flames shot out of the fifth floor window, spreading to the apartment above. The thick, black smoke instantly filled the stairwells all the way to the top floor, trapping residents who were trying to escape.
Witnesses say a mother briefly dangled her two-year-old child out of a broken 21st floor window to try to get some fresh air.
Several firefighters were injured fighting the blaze.
The building is in a sprawling complex that houses nearly 500 people and more than 20 stores.