The disaster added to a string of deadly blazes that have plagued China despite official efforts to improve public safety over the past two decades.
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The fire broke out at the four-story Beilong Hot Spring Hotel in Harbin's Sun Island recreation area at 4:36 a.m. and was extinguished at 7:50 a.m. by a force of 105 firefighters with 30 firetrucks, state television reported.
Firefighters found 16 people dead and three more died at a hospital, the city government and provincial fire department said on their social media accounts. It said 18 people were injured and a total of 70 evacuated.
The cause was under investigation, the Xinhua News Agency said.
Harbin, with about 5 million people, is the second-largest city in China's northeast, after Shenyang. It is known for the Russian architecture of its inner city and as the site of a winter festival with sculptures made of ice blocks cut from the Songhua River.
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The ruling Communist Party has tried to improve fire safety following deadly blazes at hotels, shopping malls and apartment buildings. But the country still suffers major fires.
In November, a fire blamed on faulty wiring at a Beijing apartment building killed 19 people.
A 2010 blaze at a Shanghai apartment tower killed at least 58 people. Authorities blamed sparks from a welder's torch.