A £50m development in Cardigan which will see a new hospital, GP surgery and a supermarket built, has been backed by councillors.
A new hospital and GP surgery will be built in Cardigan
The Bathhouse site project has been controversial and was subject of a public inquiry last year.
Work is now expected to start at the site later this year and finish in about 18 months, said developers Liberty Mercian.
But objectors predict the development will result in "huge" traffic problems.
Emyr Williams, development director of Liberty Mercian, said his firm was approached by Ceredigion Council to come up with ideas to develop the site.
"We've worked in partnership with the council and this development will provide more town centre facilities, plus a hospital and GP surgery," said Mr Williams.
"We have worked with the Welsh assembly and addressed the concerns of a public inquiry last year."
He added that some social housing and other retail outlets, as well as a link road, will also be built.
"Councillors have taken a very bold and courageous step in backing this project," said Mr Williams.
But Ceredigion Councillor Ian ap Dewi predicted that the project would cause traffic problems in the town.
"I think this will cause huge traffic problems," he said.
"Traffic is increasing all the time and in 10 years there may be more than Cardigan can take."
Liberty Mercian has also worked on a similar development in Aberystwyth during the last year.
A small shopping area has been built on the old livestock market in the town.