Clashes are said to have broken out as fans flooded the field seconds after the game in the northern coastal city of Port Said finished.
There were reports of rocks, bottles, flares and fireworks being thrown as politicians in the country criticised a lack of security at the match.
Doctors treating the victims said some had been stabbed to death. One player caught up in the rioting described it as "a war".
Witnesses said most of the deaths involved people who had been trampled in the crush of panicked crowds, or who fell from terraces.
Deputy health minister Hesham Sheiha told state television: "This is unfortunate and deeply saddening. It is the biggest disaster in Egypt's soccer history."
Fans of the home team, Al Masry, swarmed the field after a rare 3-1 win against Al Ahly, one of Egypt's top teams.