The Traffic and Parking Commission approved changing Lafayette Street and James Robertson Parkway to two lanes on Monday afternoon.
The decision came after a meeting with residents of 5th Avenue who spoke out against the change.
Opponents cited concerns with traffic, loading/unloading of customers and musician and the lack of public awareness of the change.
"I think you need to think long and hard about the repercussions we are going to feel down the road," business owner Barrett Hobbs said.
Homeowner Elizabeth Hood said she spent a good part of Saturday collecting signatures from her neighbors who oppose changing the road into a two-way street.
"I live in a little community and they are fixing to change the dynamic for the residents there and make it a thorough fare," Hood said.
A number of developers, including the CEO of the Music City Center, spoke out in support of the change.
"When I look at it from the Nashville Convention Center side and our plans for redevelopment between Broadway and Commerce Street at this time there are a number of our redevelopment opportunities we are exploring there," Charles Starks said, "where two-way traffic is maybe not essential, but is certainly beneficial to us."
Representatives from the Omni Hotel said the road would be the main source of access for the hotel's retail.
"We are in support of changing 5th Avenue from one-way to two-way because all of our retail for our hotel will be on 5th Avenue across from the music city center," Director of Sales and Marketing for the Omni Hotel Tod Roadarmel said.
Opponents were able to convince thee parking commission to defer action on the road during its March meeting.
The goal was to give homeowners and businesses owners time to meet with public works officials to learn more about the plan, but homeowners said that did not happen.
Portions of 5th Avenue will likely serve as a corridor for the planned Bus Rapid Transit East-West Connector that will run along a 7.5-mile corridor that stretches from Five Points in East Nashville to the Saint Thomas Hospital area in West Nashville.
Fifth Avenue is expected to be turned into a two-way road by the end of May.
People who oppose the change can appeal the parking commission's decision with the Davidson County Chancery Circuit court within 60 days.