The bus, en route from the tourist city of Pokhara to the capital city Kathmandu, fell more than 200 metres (655 feet) into the Trishuli River in Dhading district in the early hours of Monday morning.
“Out of 44, in total 19 people died, and 25 are undergoing treatment,” senior local police officer Prakash Dahal told AFP, confirming one British citizen was among the dead.
Read: Powerful winter storm shuts schools, disrupts travel across US Northeast
One Chinese person and a New Zealander were injured, he said, without giving further details.
Mohan Prasad Neupane, information officer at the district administration office, said the rescue operation had been completed by dawn.
“The injured are undergoing treatment,” Neupane said.
Read more: What does Trump want in Iran?
In July 2024, two buses with more than 50 people on board were swept off the highway into the same river after a landslide.
Deadly crashes are relatively common in the Himalayan republic because of poor roads, badly maintained vehicles and reckless driving.