Army helicopters have flown hundreds of Dresden hospital patients away from advancing floods as a wall of water sweeps downstream from the Czech Republic into southern Germany.
Several hundred patients were flown to cities as far afield as Cologne and Berlin as the German authorities rushed to empty historic Dresden, already flooded waist-deep in places, ahead of water expected to crest later in the night.
While the city braced itself for more damage, residents of medieval Prague expressed relief that frantically erected defences had kept flood waters from inundating the precious Old Town area.
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Czech emergency workers said the River Vltava, which flows into the Elbe and on to Dresden, 270 kilometres to the north of Prague, had ebbed slightly, receding from the top of heavy steel barriers thrown up to protect the Old Town area.
"It's a good sign, but there is still a long way to go. The water is still rushing quite fast, and it's still extremely dangerous," said rescue worker Mr Petr Manes.
Police reinforcements were summoned in Germany as thousands of residents of cities in Saxony such as Chemnitz and Leipzig fled water pouring over the banks of the River Elbe.
Other cities further down the Elbe, including Dessau and Magdeburg, capital of neighbouring state Saxony Anhalt, were also preparing for the worst as a wave of flooding that has swamped much of central Europe flowed deep into Germany.
The river was set to crest at a 150-year high of 8.5 metres well above the seasonal norm of two metres.
Torrential rain has wreaked havoc across Central and Eastern Europe in the past week, causing floods across Russia, Romania, Austria and Germany that have killed more than 80 people.
Hundreds more have died in seasonal floods in South Asia and Iran. The chaos has been blamed by some on changes to the global climate wrought by man-made pollution.