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Capt. Moussa "Dadis" Camara seized power in Guinea after a military coup in December and has angered his opponents by refusing to say he will opt out of presidential elections in January.
During a demonstration against him, held in a stadium in the capital Conakry on Sept. 28, Camara's troops opened fire on the crowd, killing 157 people, according to a local human rights group. Witnesses also reported that troops raped women protesters.
"We were appalled and outraged by the recent violence in Guinea," Clinton said during a news conference with Pakistan's foreign minister on Tuesday, reported Reuters. "The indiscriminate killing and raping ... by government troops was a vile violation of the rights of the people of that country."
"We intend to pursue appropriate actions against the current administration in that country," Clinton said.
"The leadership of Guinea owe a profound apology to the people, who had gathered in peaceful protest against the military takeover," she said. "They owe not only that apology in words, but in a recognition that they cannot remain in power, that they must turn back to the people the right to choose their own leaders."
The Guinea government put the death toll at 56 and said many people were trampled at the stadium.
Sidya Toure, a former prime minister, who was at the stadium and was beaten by soldiers, said about 20 were indeed trampled in the frenzy of running from the bullets, but insisted there was gunfire.
"I saw people falling in front of me. I said, 'Why are these people falling?'" he told the New York Times. "I absolutely saw soldiers firing directly on people."
On Monday, William Fitzgerald, deputy assistant secretary of state, met with Camara for two hours and said he insisted, in strong language, that Camara was responsible for the violence, despite his denials, according to the Times.
"The message is, what happened on Sept. 28 is totally unacceptable, from every way you look at it -- the killings, the gender violence," said Fitzgerald. "I said, 'Mr. President, whether you like it or not, it's tied to you. You are responsible for Sept. 28. The buck stops with you.'"
He said the response from the captain was noncommittal.
U.S. diplomats had previously refused to meet with Camara, but the violence last week dictated a meeting, unnamed diplomats told the New York Times.
The Economic Community of West African States, an alliance of West African nations, put the president of Burkina Faso, Blaise Compaore, in charge of mediation between the government and opposition groups.
Guinea's main opposition coalition is demanding that Camara step down before it will engage in talks with the ruling junta, Reuters reported.
One of the opposition officials, Ba Oury, also said they are calling for the arrest of soldiers who fired at the protesters last week.
---- Compiled from wire reports and other media sources
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