Lake effect snow warnings are in effect from Cleveland to Syracuse, New York, as intense snowfall slams the region.
In Ohio, schools including the Cleveland Metropolitan School District are closed on Tuesday due to the weather.
At least 23 vehicles have been involved in weather-related crashes on Ohio's Interstate 271, resulting in serious injuries, according to the Ohio State Highway Patrol.
Snowfall rates have been as high as 2 inches per hour in the most intense snow bands in western New York.
The biggest snowfall was 20 to 23 inches, recorded north of Syracuse.
Up to 16 inches of snow was recorded south of Buffalo, New York, and up to 13 inches fell east of Cleveland.
The snow is expected to continue through early Wednesday. Some areas could see another 1 foot of snow.
This snowstorm comes as some of the coldest air of the season hits the Northeast.
On Wednesday morning, the wind chill -- what the temperature feels like -- is forecast to plunge to 19 degrees in New York City and 17 degrees in Boston. In the South, the wind chill is forecast to fall to 19 degrees in Nashville, Tennessee; 22 in Atlanta; and 30 in Jacksonville, Florida.