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The fire broke out at about midnight on Wednesday at Grand Diamond City, a casino and hotel in the town of Poipet, near the border with Thailand, according to Cambodian police.
By Friday morning, 19 people were confirmed dead and over 60 injured.
The injured and dead included Thais, Chinese, Malaysians, Vietnamese and Cambodians, Sek Sokhom, head of the Banteay Meanchey provincial information department, was quoted as saying in an AP report on Friday.
It is not clear yet if any Vietnamese died in the accident, which Cambodian Prime Minister Hun Sen on Friday called "a tragedy at the end of the year."
About 400 employees and patrons were at the casino when the fire broke out, according to Reuters.
Sokhom said the number of deaths could exceed 20, with 60 people injured.
The Cambodian government has set up a committee to investigate the cause of the fire, which remained unclear, Reuters reported.
A key part of Cambodia's tourism industry, casinos in the capital of Phnom Penh and on the borders with Vietnam and Thailand are a draw for visitors from Asian nations that ban gambling.
Many Vietnamese have been tricked and forced to work in casinos or for illegal companies in Cambodia.
After the Cambodian authorities ramped up efforts to stamp out human trafficking in the country earlier this year, border personnel in Vietnamese localities repeatedly received repatriates from Cambodia.
As of late September, over 1,000 Vietnamese tricked into going to Cambodia as illegal workers have been rescued, according to Vietnam's Ministry of Foreign Affairs.
