Iran International
The Western Iranian province of Ilam has emerged as one of the epicenters of nationwide protests, with some of the deadliest confrontations yet between demonstrators and security forces.
Roughly half of all reported fatalities so far—around 20 protesters—have occurred by direct gunfire in western provinces, according to activist and local reports.
Many of the deaths have occurred in Ilam, Lorestan, Chahar-Mahal and Bakhtiari, and Kohgiluyeh and Boyer-Ahmad, areas that have long ranked among Iran’s most economically deprived and are home largely to ethnic Kurdish and Lor populations.
The scale of unrest has been especially striking in Ilam.
On Tuesday night, videos showing large crowds protesting peacefully in Abdanan, a city of about 25,000, circulated widely on social media, surprising many Iranians.
A day later, similarly large demonstrations took place in Aligudarz, a city of fewer than 100,000 in neighboring Lorestan, where crowds chanted slogans against Supreme Leader Ali Khamenei.
Witness accounts and videos suggest participation levels unusual for cities of that size—an indication, activists say, of how deeply economic grievances and political anger have penetrated Iran’s smaller, poorer communities.
Despite this, state media have continued to minimize the protests.
The state-affiliated Tasnim News Agency described demonstrations in Lorestan as failed “riots,” claiming people “did not show up,” while acknowledging that inflation there has exceeded the national average.
Attack on hospital
Anger across Ilam intensified further after events at Imam Khomeini Hospital in the provincial capital on Sunday, following the transfer of wounded protesters from demonstrations in Arkavaz, the center of Malekshahi county.
State outlets accused protesters of attacking the hospital, saying police entered the facility to restore order. Eyewitnesses, however, described a security raid in which tear gas was fired inside the hospital and injured protesters were removed.
A rare on-the-ground report by the moderate daily Ham-Mihan, citing multiple witnesses and medical staff, said protesters arriving at the hospital were unarmed and had been shot after a peaceful march.
Several were already dead on arrival, while others later died from gunshot wounds, including injuries caused by military-grade bullets. Some families, the report said, rushed wounded relatives out of the hospital to prevent their arrest.
The incident drew a rare official response from the government.
The Health Ministry stressed the “sanctity” of medical facilities, saying any entry by security forces into hospitals or harm to patients violated humanitarian principles.
Government spokeswoman Fatemeh Mohajerani said damage to medical centers was unacceptable “under any circumstances” and announced that President Masoud Pezeshkian had ordered an investigation, dispatching a representative to Ilam to prepare a report.
For many residents, however, the episode has come to symbolize a broader breakdown: a protest movement spreading from Iran’s margins, met not only with lethal force in the streets, but—according to witnesses—even inside places meant to offer refuge.
US forces captured Venezuelan President Nicolas Maduro in a daring, deadly raid over the weekend and launched a surprise attack on Iranian nuclear sites in June.
His maverick military style may visit Iran once again after he twice warned Washington's sworn enemies in the Islamic theocracy against killing protestors, after which over 25 people have been killed.
The question now confronting Washington is whether Donald Trump will stick to pressure and covert tools or move toward a more dramatic confrontation.
Those who follow Trump’s foreign policy decisions see a clear pattern. He favors actions that create leverage without committing the US to open-ended wars.
Drawing on that record, Dr. Mehrzad Boroujerdi, Vice Provost and Dean at Missouri University of Science and Technology and a longtime scholar of Iranian politics, described a president inclined toward targeted operations rather than large deployments.
Trump, he explained, “prefers low risk and no boots on the ground model of a surgical attack.”
In the most extreme versions of surgical-strike planning, even the Supreme Leader appears as a hypothetical target, especially after Trump said during hostilities in June that the United States was well aware of his hiding place.
A broader conflict, Boroujerdi added, would come with serious complications.
“Any type of serious military intervention, meaning boots on the ground, in a place like Iran is going to be politically risky, legally contested and strategically rather complex.”
Is a Venezuela-style scenario possible?
The dramatic operation that removed Venezuela’s Nicolás Maduro has raised questions about whether something similar could unfold in Iran.
Alex Vatanka, director of the Iran Program at the Middle East Institute in Washington, pointed to the depth of foreign intelligence penetration in Iran’s security apparatus.
“If we look at the 12 day war we just had in the summer of 2025, clearly Israel, certainly in the United States, I’m sure they have many eyes and ears inside the Iranian regime. Otherwise they could not have done the sort of targeted assassinations that they achieved.”
During the 12-day war, Israeli airstrikes targeted Iran’s nuclear and military infrastructure, killing senior commanders such as Revolutionary Guards Brigadier General Davoud Sheikhian and several nuclear scientists including Abdolhamid Minouchehr and Mohammad Mehdi Tehranchi.
That level of access, Vatanka said, creates the possibility of deals inside the ruling elite if they decide the current path is unsustainable.
“That suggests defections. That suggest a good part of an existing regime decides, you know what, going forward things have to change and they might have cut a deal.”
Boroujerdi said Washington may not rely on exiled figures. Instead, it could negotiate with people already in power.
“The Venezuela model definitely shows … that instead of choosing an opposition figure, the Trump administration is quite content with striking a deal for a negotiated transition with the elements of the regime,” he said.
But Iran’s internal structure makes such transitions unpredictable. The Revolutionary Guard dominates key sectors of the economy and the security state.
Eric Mandel, director of the Middle East Political Information Network and a frequent adviser on regional security issues, warned that power might consolidate around them.
“I think the regime change in Iran could be one where the IRGC picks up the pieces because they're the most organized force.”
Prince Reza Pahlavi, the most prominent opposition figure outside Iran and son of the deposed last shah of Iran, has taken the opposite view. In recent interviews and opinion pieces, he argued that Iran does not need foreign intervention or a Venezuela-style operation.
“We don’t need a single boot of your military on the ground in Iran,” he told the Wall Street Journal in an interview published on Monday, saying the Islamic Republic is weakening from within and that a planned transition led by Iranians themselves could prevent chaos. Supporters see him as a potential unifying figure.
Many protest videos from inside Iran feature chants invoking Prince Reza Pahlavi to return.
Do Iranians actually want an attack?
Years of inflation, corruption and repression have pushed some Iranians to consider outside intervention as a price worth paying. Yet analysts caution against assuming most people are calling for war.
Boroujerdi emphasized the economic reality first. In his assessment, “hardly anyone is asking for war because that is going to amount to even worse economic conditions.”
Protesters in Iran have appealed to US President Donald Trump for help, according to videos sent to Iran International on Tuesday, with posts and signs reading 'Trump don't let them kill us.'
US President Donald Trump said on Sunday night aboard Air Force One that the United States was monitoring developments in Iran closely and warned that if Iranian authorities killed protesters, the country would face a strong response.
Meanwhile, the make-up of protests is shifting. Demonstrations are less concentrated among Tehran’s elite and increasingly driven by smaller cities and working-class families, once supporters of the clerical establishment and pillars of the 1979 Islamic Revolution.
“Right now, 70 plus cities and towns are protesting. This is a nationwide phenomena … It’s inflation, it’s unemployment, it’s the corruption,” said Vatanka.
Police in Abdanan, in Ilam Province, are seen in footage viewed by Iran International waving and cheering on protesters - an unusual scene in a system built on loyalty to the state.
What happens if there is an attack?
Mandel believes escalation remains possible, especially around Iran’s missile program.
“I think there’s a good chance that there will be a war with Iran,” he said, warning that Tehran could also strike first to distract from domestic crises and attempt to rally nationalist sentiment.
Iran’s newly formed Defense Council warned on Tuesday that the country could respond before an attack if it detected clear signs of a threat. Israeli Prime Minister Benjamin Netanyahu said on Monday that he and Trump would not permit Iran to restore its ballistic and nuclear program.
For Iranians already living with inflation, repression and unrest, the question is no longer whether pressure will continue. It is what form it will take, and how high the price will be.
