Dozens of pilgrims jumped into a lake to escape agitated elephants that ran amok during an annual Buddhist procession in Sri Lanka, police said Wednesday.

At least one woman was hospitalised and many more injured after the stampede at the Esala Perahera parade in Kandy, a popular pilgrimage destination, on Tuesday night.

Police said five young elephants adorned with decorative coverings for the procession went berserk, forcing spectators to jump into a lake to avoid getting trampled.

The pageant was suspended until the runaway animals were chained and subdued.

Footage shared on social media showed one of the creatures shaking off its decorative clothing and charging down a street in Kandy with several handlers in hot pursuit.

After nightly parades, the religious festivities end on August 30 with the display of a relic casket -- believed to contain a tooth belonging to the Buddha -- atop an elephant.

The centuries-old cultural event has been criticised for alleged cruelty to animals, with activists demanding an end to the use of captive elephants.

Animal rights group Rally for Animals and Environment (RARE) said the creatures were forced to "walk in shackles amidst fire and loud noise in searing heat".

"It's time for Sri Lanka to stop using elephants in this cruel way," RARE chief Panchali Panapitiya told AFP.

Elephants are considered sacred in Sri Lanka, but animal cruelty laws are rarely enforced.

In 2019, at least 17 people were injured when elephants ran amok at a temple festival in Colombo.

Official records show there are about 200 domesticated elephants in the island nation, along with a wild population of around 7,500.

The government has banned the capture of wild elephants, but dozens of calves have been stolen in recent years, often after their mothers were killed by their captors.