The first convoy of people needing medical aid has begun to leave rebel-held areas in Aleppo, according to a monitoring group.
The patients will be taken through government territory into countryside held by rebel groups west of the city as agreed in a deal this week.
Around 200 people were expected to be evacuated from the devastated city on three buses and taken to a handover point in rebel-held territory.
The British-based Syrian Observatory for Human Rights said no rebel fighters were among those who had left.
But a rebel official claimed the first ambulances were shot at by pro-Assad militias as they crossed out of the east of the city, wounding three people.
Al-Farook Abu Bakr, the chief negotiator for the rebels, told AFP news agency that the first convoy would only be for wounded people, their carers and other civilians.
He said rebel fighters would be evacuated after the first or second convoy.
Russia has said the rebels will be transported on 20 buses and 10 ambulances in a corridor towards Idlib.
Soldiers will also escort them from the city under orders from President Vladimir Putin, according to state news agencies.
The Russian defence ministry said Syrian authorities had guaranteed the safety of the rebels and their families and added it would use drones to monitor the convoy.
It comes after a new agreement was reached for the evacuation of rebel fighters on Thursday.
The Ahrar al Sham rebel group said negotiators had overcome apparent obstruction by Iran and its militias to block the evacuation.
Syrian rebels have said that Turkey has played a major role in getting Russia to exert pressure on Bashar al Assad to stand by the deal after it was delayed on Wednesday as the fragile ceasefire collapsed amid more airstrikes and shelling in Aleppo.
Turkish President Recep Tayyip Erdogan and Mr Putin agreed in a phone call on Wednesday to revive the deal.
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