Tiananmen happened in 1989, the oldest I could find of that photo was 2016 (Jinjang and Hong Kong) which have since been deleted. Looks real, but could be “doctored”.
Here’s a pretty good source that backs up what the photo shows:
Reports on the number of dead were sketchy. Three Beijing hospitals reported receiving at least 68 corpses of civilians and said many others had not been picked up from the scene. Four other hospitals said they had received bodies of civilians but declined to disclose how many. Students said, however, that at least 500 people may have been killed in the crackdown.
https://www.pulitzer.org/article/army-clears-tiananmen-square
It was in the thousands
ThankQ for that analysis!