The 7.8-magnitude quake on April 25, 2015, triggered avalanches and landslides across the Himalayan nation and flattened villages.
Nepal's Prime Minister K.P. Sharma Oli attended a memorial ceremony at the site of Dharahara tower, one of many buildings that crumbled in the quake.
"We are vulnerable to other natural disasters such as floods, landslides, and are more prone to earthquakes. We need to prepare ahead against natural calamities," Oli said.
The 19th-century, nine-storey Dharahara tower toppled during the earthquake, killing more than 50 people.
A replica has been built next to the rubble of the original.
Attendees, including civil servants and local residents, observed a moment of silence at 11:56 am, the time the quake struck. Oli lit candles in memory of those who were killed.
"I would like to offer my condolences to those all who lost their lives," Oli said.
At the historic Patan Durbar Square, people recounted harrowing tales of the day.
"Whenever I remember that day, I still feel anxious," Rajshree Maharjan told AFP.
"I had just finished my meal when the quake struck. My neighbour's house collapsed, and four people were killed after being buried under the rubble."
Memorials were held in several of the affected districts across the country.
The aftermath of the quake exposed deep cracks in Nepal's disaster response system and the rebuilding efforts were initially hit by political infighting, bureaucracy and confusion.
Since then, significant progress have been made. According to official figures, nearly 90 percent of the homes destroyed have been rebuilt, alongside thousands of schools, health institutions, and public buildings.
Temples and cultural landmarks are also slowly rising again.
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