 The Tigers have been fighting for a separate homeland since the 1970s |
The US, EU, Japan and Norway have urged Sri Lanka's Tamil Tiger rebels to lay down their arms and discuss ending hostilities with the government.
The nations said there remained only a short time before the Tigers lost the territory still under their control.
Both sides "should recognise that further loss of life - of civilians and combatants - will serve no cause", the nations said.
The Sri Lankan government says it is close to defeating the rebels.
Up to 250,000 civilians may be trapped by the fighting.
'Sovereignty'
Norway, Japan, the US and the EU are described as the Tokyo Co-Chairs, who sat at the Tokyo Conference on Reconstruction and Development of Sri Lanka in 2003.
In a joint statement, they expressed "great concern" for the plight of civilians.
 | INSURGENCY TIMELINE 1976: Liberation Tigers of Tamil Eelam form in the north-east 1987: India deploys peace-keepers to Tamil areas but they leave in 1990 1993: President Premadasa killed by Tiger bomb 2001: Attack on airport destroys half Sri Lankan Airlines fleet 2002: Government and rebels agree ceasefire 2005: Mahinda Rajapaksa becomes president 2006: Heavy fighting resumes 2009: Army takes main rebel bases of Kilinochchi and Mullaitivu  |
The nations also urged both sides to "declare a temporary no-fire period to allow for evacuation of sick and wounded, and provision of aid to civilians".
The Sri Lankan government has previously ruled out any ceasefire and has vowed to crush the rebels.
The Tigers have said they will not lay down their arms until they have a "guarantee of living with freedom and dignity and sovereignty".
The Tokyo Co-Chairs said both sides "must respect international humanitarian law".
They said they would help transfer internally displaced people to humanitarian camps.
The statement comes amid reports of repeated artillery attacks on a hospital in Tiger-held territory.
The Red Cross says the hospital in Puthukkudiyiruppu town in Mullaitivu district has been hit five times in the past few days, leaving at least 12 civilians dead.
One strike was on a paediatric ward, it said.
 The Sri Lankan military has vowed to crush the rebels |
The government says it is not responsible for the attacks and has told civilians to leave the war zone. Pro-rebel websites blaming the army.
The hospital is one of the last functioning health facilities in the area.
Sri Lanka's military says it has designated a safe zone for civilians in a 32 sq km buffer zone on the A-35 main road which links Paranthan and Mullaitivu.
The zone is inside a gradually shrinking rebel enclave north of Mullaitivu.
The Tigers are proscribed as a terrorist group by many nations, including the US and the EU.
They started fighting in the 1970s for a separate state for Tamils in Sri Lanka's north and east.
Norway has been a broker in previous rounds of unsuccessful peace talks between the rebels and Sri Lanka's government.
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