Donald Trump was hit in the ear in an assassination attempt by a gunman at a campaign rally Saturday, in a chaotic and shocking incident set to supercharge political tensions ahead of the polarising US presidential election.

The 78-year-old former president was rushed off stage with blood streaked across his face after the shooting in Butler, Pennsylvania, while the shooter and a bystander were killed and two spectators critically injured.

The Republican candidate raised a defiant fist to the crowd as he was bundled away to safety, and said afterward: "I was shot with a bullet that pierced the upper part of my right ear."

President Joe Biden, who is set to face Trump in November's deeply polarized election, said the incident was "sick" and added that there was "no place in America for this kind of violence."

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Biden later spoke to Trump, the White House said.

The FBI has identified the gunman, who was shot dead, as 20-year-old Thomas Matthew Crooks of Bethel Park, Pennsylvania, according to a statement cited by US media early Sunday. His motive remains unknown.

The US Secret Service said earlier that the shooter "fired multiple shots toward the stage from an elevated position outside the rally" before being "neutralized" by agents.

A video published by US outlet TMZ shows the alleged assailant lying on his belly on a sloping rooftop and aiming a rifle. A quick succession of gunshots is heard followed by screams from off-camera Trump supporters attending the rally.

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"The guy has longer brown hair... and as you can see, he's carefully trying pinpoint a target from afar before pulling the trigger," TMZ reported. Crooks lived about 40 miles (65 kilometers) from the rally venue.

The FBI confirmed in a press conference that the shooting was being treated as "an assassination attempt against our former president, Donald Trump."

The shooter, reportedly a registered Republican, was believed to be working alone.

His father Matthew Crooks told CNN that he was trying to establish "what the hell is going on", and would not comment until he spoke to law enforcement.

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After multiple witnesses said they saw the gunman before the shooting and alerted authorities, Butler police said they had "responded to a number of reports of suspicious activity".

- 'Ripping through the skin' -

Trump, wearing a red "Make America Great Again" cap, had just started speaking at his final rally before the Republican National Convention when multiple bangs rang out.

He grimaced and clutched his ear, with blood visible on his ear and cheek, then ducked to the floor as Secret Service agents swarmed onto the podium, surrounding him and escorting him roughly off the stage to a nearby vehicle.

"It is incredible that such an act can take place in our Country," Trump said on his Truth Social network hours later, in remarks sure to stoke the political hostility already engulfing the United States.

"I knew immediately that something was wrong in that I heard a whizzing sound, shots, and immediately felt the bullet ripping through the skin," Trump said.

"Much bleeding took place, so I realized then what was happening."

He later could be seen walking unaided from his plane, though his wounded ear was not facing the camera in video footage posted by his deputy communications director. The New York Times reported that he was staying the night in New Jersey.

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Police confirmed that a spectator was killed and two critically injured in the shooting, all of them male adults.

The attack sent shock waves around the world, with the leaders of Britain, Israel, China and many other countries expressing outrage.

Biden cut short a weekend trip to his Delaware beach house to return to Washington. He will receive an updated briefing from security officials on Sunday morning, the White House said.

The attack has already stoked political tensions, with some Republicans pointing the finger at Biden and right-wing conspiracy theories flooding social media.

Possible Trump vice presidential pick J.D. Vance said Biden's "rhetoric" had "led directly" to the Trump attack.

Trump's campaign said he would still attend the Republican National Convention in Milwaukee, after he was reported to have had a precautionary hospital checkup.

- Screams and panic -

But the convention will now be dominated by the shooting at the rally, which descended into panic, with screams ringing out after the gunshots.

"Let me get my shoes," Trump was heard saying on the microphone, as security agents helped him back to his feet.

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He turned back to the crowd and repeatedly raised his fist, as well as mouthing words that weren't immediately discernible, in what instantly became an iconic image.

Agents bundled the tycoon into an SUV, as he once more shook his fist.

"We saw a lot of people go down, looking confused. I heard the shots," said John Yeykal from Franklin, Pennsylvania, who was attending his first Trump rally.

US political figures including former presidents Barack Obama and Bill Clinton lined up to condemn the attack and say there was no place for violence in politics.

Billionaire Elon Musk meanwhile reacted by quickly endorsing Trump.

The United States has a history of political violence, and presidents, former presidents and candidates have tight security.

President John F. Kennedy was assassinated in 1963 while riding in his motorcade, and his brother Bobby Kennedy was shot dead in 1968. President Ronald Reagan survived an assassination attempt in 1981.

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