The Queen condemned the "wicked" attack in Manchester as she met a North East schoolgirl recovering from injuries sustained in the suicide bombing.
Her Majesty was meeting victims at Royal Manchester Children's Hospital, and staff who worked tirelessly through the night in the aftermath of Monday's atrocity.
Twelve children under the age of 16 - among the 64 casualties - were taken to the hospital by ambulance following the terror attack.
The Queen met scores of staff who had worked through the night, shaking hands and sharing words with many, before visiting a ward where four young girls who were injured in the concert blast are recovering.
Millie Robson, 15, from Newton Aycliffe, Co Durham was wearing an Ariana Grande T-shirt as she met and shared words with the royal visitor.
The Queen asked Millie, who suffered injuries to her legs, if she had enjoyed the concert before the attack - prompting the teenager to reveal she had won two VIP passes and met the global superstar backstage.
The royal described the atrocity as "very alarming" and wished Millie a speedy recovery.
"It's not something you expect at all," the Queen said to father David, who was waiting at the exit of the arena for Millie when the bomb exploded.
The Queen told another victim Evie Mills, 14, and her parents: "It's dreadful. Very wicked. To target that sort of thing."
Prime Minister Theresa May visited the hospital on Tuesday afternoon.