TRIPOLI, Libya — The casualties at the Aziziya field hospital south of Tripoli used to arrive with gaping wounds and shattered limbs, victims of the haphazard artillery fire that has defined battles among Libyan militias. But now medics say they are seeing something new: narrow holes in a head or a torso left by bullets that kill instantly and never exit the body.

It is the work, Libyan fighters say, of Russian mercenaries, including skilled snipers. The lack of an exit wound is a signature of the ammunition used by the same Russian mercenaries elsewhere.

The snipers are among about 200 Russian fighters who have arrived in Libya in the last six weeks, part of a broad campaign by the Kremlin to reassert its influence across the Middle East and Africa.

After four years of behind-the-scenes financial and tactical support for a would-be Libyan strongman, Russia is now pushing far more directly to shape the outcome of Libya’s messy civil war. It has introduced advanced Sukhoi jets, coordinated missile strikes, and precision-guided artillery, as well as the snipers — the same playbook that made Moscow a kingmaker in the Syrian civil war.

“It is exactly the same as Syria,” said Fathi Bashagha, interior minister of the provisional unity government in the capital, Tripoli.

Whatever its effect on the outcome, the Russian intervention has already given Moscow a de facto veto over any resolution of the conflict.

The Russians have intervened on behalf of the militia leader Khalifa Hifter, who is based in eastern Libya and is also backed by the United Arab Emirates, Egypt, Saudi Arabia and, at times, France. His backers have embraced him as their best hope to check the influence of political Islam, crack down on militants and restore an authoritarian order.

Mr. Hifter has been at war for more than five years with a coalition of militias from western Libya who back the authorities in Tripoli. The Tripoli government was set up by the United Nations in 2015 and is officially supported by the United States and other Western powers. But in practical terms, Turkey is its only patron.

The new intervention of private Russian mercenaries, who are closely tied to the Kremlin, is just one of the parallels with the Syrian civil war.

The Russian snipers belong to the Wagner Group, the Kremlin-linked private company that also led Russia’s intervention in Syria, according to three senior Libyan officials and five Western diplomats closely tracking the war.

In both conflicts, rival regional powers are arming local clients. And, as in Syria, the local partners who had teamed up with the United States to fight the Islamic State are now complaining of abandonment and betrayal.

The United Nations, which has tried and failed to broker peace in both countries, has watched as its eight-year arms embargo on Libya is becoming “a cynical joke,” as the United Nations special envoy recently put it.

Yet in some ways, the stakes in Libya are higher.

More than three times the size of Texas, Libya controls vast oil reserves, pumping out 1.3 million barrels a day despite the present conflict. Its long Mediterranean coastline, just 300 miles from Italy, has been a jumping-off point for tens of thousands of Europe-bound migrants.

And the open borders around Libya’s deserts have provided havens for extremists from North Africa and beyond.

The conflict has become a bipolar combination of the primitive and futuristic. Turkey and the Emirates have turned Libya into the first war fought primarily by clashing fleets of armed drones. The United Nations estimates that during the past six months, the two sides have conducted more than 900 drone missions.

But on the ground, the war is between militias with fewer than 400 fighters typically engaged on both sides at any time. The fighting happens almost exclusively in a handful of deserted districts on the southern outskirts of Tripoli, while in neighborhoods just a few miles away, streets are clogged with civilian traffic and espresso bars bustle amid heaps of uncollected garbage.

“There is a huge discrepancy between the Libyan fighting on the ground and the advanced technology in the air from the meddling foreign powers,” said Emad Badi, a Libyan scholar at the Middle East Institute who visited the front in July. “It’s like they are different worlds.

On a recent tour of the front-line district of Ain Zara, a Tripoli militia officer, Muhammad el-Delawi, passed out stacks of cash to fighters in T-shirts or mismatched camouflage uniforms, some in tennis shoes or sandals, others only with bare feet. The twisted wreckage of an ambulance hit by a drone missile sat by the side of the road.

The arrival of the Russian snipers is already transforming the war, Mr. el-Delawi said, recounting the deaths of nine of his fighters the previous day — one of them shot in the eye.

“The bullet was as long as a finger,” he said.

One European security official said the absence of exit wounds, a mark of hollow-point ammunition, matches injuries inflicted by Russian snipers in eastern Ukraine.

By the beginning of April, the conflict had largely died down and the United Nations secretary general, António Gutteres, arrived in Tripoli to try to finalize a peace deal. But the next day Mr. Hifter launched a surprise assault on the capital, restarting the civil war.

Officials of the Tripoli government say Russia is now bringing in more mercenaries by the week.

“It is very clear that Russia is going all in on this conflict,” said Gen. Osama al-Juwaili, the top commander of the forces aligned with the Tripoli government. He complained that the West was doing nothing to protect that government from the foreign powers determined to push Mr. Hifter into power.

“Why all this pain?” he said sardonically. “Just stop this now and assign the guy to rule us.”

Russia had previously stayed in the background while the United Arab Emirates and Egypt took the leading roles in military support for Mr. Hifter. But by September, his assault on Tripoli seemed to have stalled and Russia apparently saw an opportunity.

Given the amateurish nature of the ground fighting, some diplomats said, the arrival of 200 Russian professionals could have an outsized impact.

A spokesman for Mr. Hifter’s forces did not respond to a request for comment.

Having collapsed into feuding city-states after the overthrow of the longtime Libyan dictator Col. Muammar el-Qaddafi in 2011, Libya is less a functioning state than a vast and bloated public payroll. Citizens and towns are united only by a shared dependence on the oil revenue flowing through the national bank in Tripoli to a vastly inflated government work force. Some of those salaries ultimately end up paying fighters on all sides of the war.

Control of the central bank and the oil revenue has made Tripoli the war’s grand prize.

Mr. Hifter, 75, was a former army general under Colonel el-Qaddafi who defected and lived in Northern Virginia as a C.I.A. client for more than a decade. Returning to Libya in 2011, he sought but failed to win a leading role in the uprising.

Five years ago, he vowed to rule Libya as a new military strongman, but his progress has been halting. His limited success has depended heavily on his regional backers and, until now, Russia appeared to have hedged its bets.

The Kremlin has maintained contacts with the authorities in Tripoli as well as with former el-Qaddafi officials, even as its support for Mr. Hifter has been vital and growing.

Russia has printed millions of dollars’ worth of Libyan bank notes and shipped them to Mr. Hifter. By 2015, Russia had set up a base in western Egypt to help provide technical support and repair equipment, according to Western diplomats. By last year, Russia had also sent at least a handful of military advisers to Mr. Hifter’s forces in Benghazi.

Last November, Mr. Hifter was filmed at a table in Moscow with both the Russian defense minister and the head of the Wagner Group, Yevgeny Prigozhin, the close ally of Russia’s president, Vladimir Putin. Mr. Prigozhin is under indictment in the United States for involvement in the internet “troll farm” that sought to influence the 2016 presidential election.

As in Syria, the Russian escalation in Libya has drawn complaints from former American allies that Washington has abandoned them.

Even though it officially supports the United Nations-recognized government, the United States has largely disengaged and President Trump has appeared to endorse Mr. Hifter. Mr. Trump called Mr. Hifter a few days after he began his assault on Tripoli to applaud his “role in fighting against terrorism.”

Now Mr. Hifter’s forces are conducting airstrikes against militias from western Libya that had previously worked closely with American military forces to expel a branch of the Islamic State from its stronghold in the city of Surt.

“We fought with you together in Surt and now we are being targeted 10 times a day by Hifter,” Gen. Muhammad Haddad, now a commander for the Tripoli forces, said he told American officials.

When Mr. Hifter began his assault on Tripoli in April, his biggest advantage was the use of armed drones: The United Arab Emirates furnished Chinese-made Wing Loong drones, purchased for $2 million each.

General al-Juwaili blamed drone strikes for nearly two-thirds of the casualties among Tripoli government forces. United Nations officials estimate that more than 1,100 have died in the fighting but say the real number is likely more than double.

“In the beginning, we were terrified,” said Mr. el-Delawi, the officer of the Tripoli-backed militia at Ain Zara. “We just heard a scary noise and we did not know what to do.”

Since then, he said, fighters have learned to listen for the whirring noise and hide as the drones approach. They say Mr. Hifter’s forces can fly only three drones at a time, and that each drone fires a maximum of eight missiles. Each must then disappear to reload — allowing the fighters a chance to regain lost ground.

Realizing that the drones target heat sources, the fighters also learned to hide more effectively, including by refraining from smoking.

“The drone can see a fighter smoking a cigarette inside a car,” Mr. el-Delawi explained.

In May, the Tripoli government began buying drones from Turkey: The Bayraktar TB2 sold for $5 million each and is manufactured by the family business of President Recep Tayyip Erdogan’s son-in-law, Selcuk Bayraktar.

“The Turks saved us just in time,” said Mr. Bushagha, the interior minister of the Tripoli government.

Turkish drones helped the Tripoli forces recapture the strategic city of Gheryan in June, and since then, the battle lines have barely shifted.

Taking Tripoli may require far more Russian support than a couple hundred mercenaries, given the bloody block-by-block nature of urban combat. But by propping up Mr. Hifter, diplomats said, Moscow has already claimed a major say in any negotiations over Libya’s future.

In an interview, the United Nations envoy, Ghassan Salame, said Libyans could patch up their differences if foreign powers stopped arming rival factions. He has organized a conference in Berlin later this year to try to stop that interference.

“Otherwise, this could either go on for an eternity as a low intensity conflict, like a fire that is not extinguished,” he said, “or even escalate, with a doubling down by the international forces intervening, if they believe they can somehow end it for their own advantage.

Michael Schwirtz contributed reporting from New York.

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