The gaming compact was one of the first measures the Senate took up Wednesday, the opening day of the short session.
State law doesn't currently allow live dealers at table games, even at Indian casinos. The proposal would allow them in return for a share of the profits from the games.
Governor Bev Perdue's office has been negotiating the compact for months.
It's expected to create about 400 jobs in the far western counties, where unemployment rates are higher than the state's average.
The bill passed by a 33 to 14 vote that didn't break down along partisan lines.
Senate Rules chairman Tom Apodaca, R-Henderson, said western lawmakers have been pushing for the change for a decade.
"What this bill simply does is allow the Cherokee nation to place live dealers where they have machines now,” Apodaca said.
Apodaca conceded the change might lead to more gambling. But, he said, "Human beings should be able to make their own choices in life.”
But Senator Dan Soucek, R-Watuaga, voted against the bill because of social concerns about expanding gambling.
"It's not an industry where things grow," Soucek said. "It’s just an exchange. You’re not creating anything. I don’t like the economics of it, and I don’t like the problems it causes to families."
The measure now moves to the state House, where it may face a tougher battle. Its critics there include Majority Leader Paul Stam, R-Wake.