At least 40 were left dead and 70 others wounded when fierce clashes erupted between militants and rebels near Damascus on Friday, a monitoring group said.
The clashes pitted the Saudi-backed rebel faction Jaish al-Islam (Army of Islam) against Fateh al-Sham, al-Qaeda's former branch in Syria, and Faylaq al-Rahman, which is backed by Qatar and Turkey, the Syrian Observatory for Human Rights said.
"There were at least 15 dead among the ranks of Jaish al-Islam and 23 among its adversaries" as well as two civilians, the Britain-based Observatory said.
Jaish al-Islam said its opponents had provoked the clashes by harassing reinforcements headed for Qabun, east of the Syrian capital, a front with regime forces.
Faylaq al-Rahman denied the allegation.
In May 2016, more than 300 people were killed in a battle between the two sides.
Syria's war has left more than 320,000 people dead since it began with protests in 2011 that were brutally repressed by the government of President Bashar al-Assad.
Regional and international powers have since been drawn into the complex conflict, in which internationally prohibited weapons such as cluster bombs and toxic gas have been used.
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