A twin attacks that took place late on Friday_ and the fact that the bombers were able to infiltrate areas that were supposed to be secure _ left people in Tikrit feeling under siege.
It was the third major attack in Tikrit this year, reflecting the difficulties Iraqi security forces face in protecting their own people from Sunni insurgents still intent on undermining the country's post-Saddam leaders, many of whom are Shiite. Such violence is all the more troubling because of the approaching year-end deadline for American forces to leave.
The first bomber struck during midday Muslim prayers, blowing himself up inside a Sunni mosque packed with local officials and killing 16 people, including a police commander and a judge, officials said.
The mosque was inside a government-controlled compound where many officials live, and most in attendance were security or government employees.
Victims were taken to the main hospital in Tikrit, said the province's top medical official, Dr. Raeid Ibrahim. He said 54 people were wounded.
Hours later, another suicide bomber walked into the hospital and blew himself up near the emergency room, where family members had gathered, said Mohammad al-Asi, the media adviser for the Salahuddin provincial governor.
Five people were killed and 16 were injured, said an official at the hospital and a security official in Tikrit.
They spoke on condition of anonymity because they were not authorized to speak to the media.
There was no immediate claim of responsibility for either attack. Sunni insurgents often target fellow Sunnis who work with the government because they perceive them as collaborators with Iraq's Shiite-dominated leadership. Many of the Sunni extremists view Shiites as infidels and non-Muslims. Iraq's majority Shiites were persecuted under Saddam's Sunni-led regime.
Tikrit, 80 miles (130 kilometers) north of Baghdad, was Saddam's hometown, and many of his relatives and supporters still live there. It is the capital of the Sunni-dominated Salahuddin province, and the city sheltered some of al-Qaida's most fervent supporters after the 2003 U.S.-led invasion ousted Saddam.
Two other deadly attacks hit the city earlier this year.
In March, gunmen strapped with explosives stormed the provincial council building and held off Iraqi forces for five hours before blowing themselves up; 56 people were killed, including 15 who were shot execution-style in the head.
On Jan. 18, a suicide bomber killed 52 people among a crowd of police recruits in Tikrit. The bomber had joined hundreds of people waiting outside a police station to submit applications for 2,000 newly created jobs.
Even before Friday's attacks, the violence in Tikrit had local officials deeply worried. They said they have been taking steps to protect themselves, often changing vehicles and the time and location of meetings at the last minute in order to foil attacks.
But for an insurgent intent on killing as many people as possible, Fridays provide easy targets because that is when Muslims gather in mosques at midday for the week's main prayer service.
"We couldn't change the prayer time," said Ahmed al-Ikraim, the deputy governor for Salahuddin province. Among the dead were a police commander, a judge and the husband of a provincial council member.
Attacks inside hospitals have been rare in Iraq, but insurgents trying to maximize damage often carry out secondary attacks targeting rescuers and security forces responding to the scene of earlier bombings.
"We evacuated visitors from the hospital," said Amar Yousef, the head of the Salahuddin provincial council.
"The Iraqi army is deployed in the streets." He said officials were worried that there was another explosive vest somewhere in the hospital but a search of the building did not find anything. A curfew was in effect across the city.
Violence has decreased dramatically across Iraq since the heyday of the insurgency, but it has not been wiped out entirely. American forces are scheduled to leave Iraq by the end of this year under an agreement signed in 2008.
As the deadline approaches, many Iraqis and lawmakers are questioning whether the country is ready. Prime Minister Nouri al-Maliki has said he will meet with Iraqi political blocs to discuss whether American forces should stay longer, but so far there has been no request on the Iraqi government's part.
A parliament member from Salahuddin province, Quotayba al-Jabouri, said the attack on the mosque in the government compound shows that Iraq still needs American support.
"You can imagine if there is infiltration and a breach in such a place, what is the situation like outside?" he said.