First responders from multiple agencies combed through destroyed homes and businesses in rural Bollinger County, which Missouri Governor Mike Parson said faced "a long journey ahead" towards recovery.
Five people were also injured and 87 structures damaged with 12 of those buildings destroyed, said Eric Olson, superintendent of the Missouri State Highway Patrol.
Photographs on social media from Glen Allen, Missouri - a village about 180 kilometres south of St Louis - showed severely damaged houses with roofs torn off, downed trees and power lines and debris covering roadways and yards.
"It's just heartbreaking to see people's homes missing roofs and their homes gone," Missouri State Patrol Highway Sergeant Clark Parrott told Reuters said after surveying the damage.Â
"We got work ahead of us, but we will get through this."
Storm spotters reported the tornado touched down in the area early on Wednesday, according to the National Weather Service, one of more than a dozen twisters seen in the midwest overnight.
Parson said the state would aid people who lost their homes even though some sparsely populated communities would not have sustained enough damage to be eligible for public disaster relief.
"This is going to be weeks upon months to be able to recover," Parson said, adding that President Joe Biden called to offer help and services.
The twister struck days after violent tornadoes tore through parts of the south and midwest, killing at least 32 people.
A week before, a tornado devastated the Mississippi Delta town of Rolling Fork, killing 26 people.
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