At around 12:50, a white pickup truck pulled up to the Uthai Sawan nursery. The driver, thirty-four-year-old Panya Khamrab, had left his home earlier that morning and attended a court hearing on drug charges. He arrived at the nursery armed with a legally purchased SIG Sauer P365 pistol and a knife. He first shot a father and son near the entrance and killed a teacher who was eight months pregnant. Several staff members fled. Then Khamrab entered the room where the children were sleeping. Of the thirty children present, twenty-two were killed inside the nursery - nineteen boys and three girls. Khamrab fled in his truck, shooting and killing more people as he drove through the Nong Kung Si district, including two more children. When he reached his home, he killed his wife and stepson, set his truck on fire, and turned the weapon on himself. In total, thirty-six people died, including twenty-four children. The youngest victims were three years old; the oldest was sixty-nine.

Khamrab had been a police sergeant in Na Wang district before his dismissal, which was linked to a long-standing methamphetamine addiction that dated back to high school. In January 2022, he had been arrested for drug possession. He was separated from his wife. Colleagues described mood swings and erratic behavior - he had allegedly threatened a bank manager with a pistol after being found sleeping on duty, argued with his wife over a suspected affair, and disturbed neighbors with loud house parties. On the morning of the attack, he appeared in court for one drug hearing and was scheduled for another the following day. Every element of a person in crisis was visible. None of it triggered intervention sufficient to prevent what followed. The weapon used in the massacre had been legally purchased.

Prime Minister Prayut Chan-o-cha arrived in Nong Bua Lamphu the day after the attack to meet survivors and victims' families. He described the event as "shocking" and ordered investigations and tighter measures on both gun control and drug enforcement. All government institutions flew their flags at half-mast. Daycare centers in the area were closed. At the provincial hospital, doctors issued an urgent call for blood donations as the community organized to help the wounded. King Vajiralongkorn placed all victims under royal patronage, covering funeral expenses for the dead and medical costs for the survivors. He personally visited the hospital to meet with the families. UNICEF condemned the attack and urged that images from the scene not be shared publicly, calling on all parties to protect the dignity of the children and their families.

International condemnation came swiftly. The U.S. State Department, British Prime Minister Liz Truss, and Australian Prime Minister Anthony Albanese all issued statements. But the deepest impact was felt locally, in a rural province where a nursery had been a place of safety and routine - where parents dropped off toddlers before work and picked them up in the afternoon. The massacre was the deadliest in Thailand's modern history, surpassing the 2020 Nakhon Ratchasima shootings. It forced uncomfortable national conversations about methamphetamine's grip on communities, about the ease of legal gun purchases by individuals with documented drug problems, and about the gaps in a system that dismissed a former officer spiraling through addiction and personal collapse. In Uthai Sawan, the conversations were simpler and harder. Parents buried their children. Mental health counselors arrived at the nursery that evening to sit with families who had come looking for answers that did not exist.