The incident brought swift worldwide condemnation, with France and Britain demanding an emergency UN Security Council meeting and President Francois Hollande denouncing a "massacre".
Warplanes later struck near a medical point where victims of the attack were receiving treatment, the Observatory and civil defense workers said.
March 19, 2013: The Syrian government and opposition trade accusations over a gas attack that killed some 26 people, including more than a dozen government soldiers, in the town of Khan al-Assal in northern Syria.
UPDATED 7.57AM A suspected Syrian government chemical attack has killed scores of people, including children, in the northwestern province of Idlib. "Like in 2013, Bashar al-Assad counts on the complicity of his allies to act with impunity", Hollande said in a statement on Tuesday.
Worldwide law prohibits chemical attacks.
"The regime has been systematically using small scale (chemical) attacks over a long time in order to normalize the use of those attacks", said Haid, an associate fellow at Chatham House.
"The toll continues to increase as do the strikes in the Idlib region as well as non-chemical attacks in Hama", the group said.
"What we have understood, it was a chemical attack and it came from the air", de Mistura told reporters in Brussels, adding that there should be a "clear identification of responsibilities and accountability".
The attack came just ahead of the opening of a planned global meeting of United Nations members, European Union members and some financial institutions throughout the world to discuss the current state and future of Syria.
Tuesday s attack cast new doubt on the peace process, said the opposition s chief negotiator Mohamad Sabra.
Claims of chemical weapons attacks, particularly the use of the chlorine agent, are not uncommon in Syria's conflict.
"If this were to be proved to have been committed by the Assad regime, then it would be another reason to think they are an absolutely heinous outfit, that is, it is a war crime", Johnson said.
The Syrian government did not immediately comment on the allegations, but last week said claims the government was using chemical weapons were "devoid of truth".
The Britain-based monitoring group was unable to confirm the nature of the substance, and said it was unclear if the planes involved in the attack were Syrian or those of government ally Russian Federation.
France's foreign minister is calling for an emergency U.N. Security Council meeting over a suspected chemical attack in Syria's rebel-held Idlib province.
Meanwhile, the Idlib Media Center said dozens of people had been killed.
However, the airstrike that took place this morning in Idlib claiming dozens of lives utilized sarin nerve gas: a lethal gas that has been defined by the United Nations as a weapon of mass destruction and has been prohibited for use and collection by the Chemical Weapons Convention. Obama opted against a military response and instead for a negotiated deal in which Syria surrendered its chemical weapon stockpile, a move that was heavily criticized by conservatives and others.
The worldwide inquiry found Syrian government forces were responsible for three chlorine gas attacks and that Islamic State militants had used mustard gas.
The doctor, who can not be named for security reasons, said tests were needed to identify if sarin gas was to blame.
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