Israel’s government approved a ceasefire deal with Hamas early Saturday that calls for the release of dozens of hostages and hundreds of Palestinian prisoners after hours of deliberations, marking the first reprieve in the 15-month, devastating war in the Gaza Strip.

The Israeli prime minister’s office, which announced the deal after a vote by the full cabinet, said the agreement would take effect on Sunday.

The Palestinians celebrated the temporary ceasefire with the hope of finally ending the conflict, and the Israelis anxiously await the return of the many prisoners kidnapped by Hamas.

Daniel Lifshitz, whose grandfather Oded, 84, was among the 250 prisoners taken in the October 7, 2023 Hamas attack on Israel, said: “The stomach is turning and the heart is spilled on the floor, but it is what we have been waiting for.”

The initial attack killed about 1,200 people, triggering a wave of bombings by Israel that killed more than 46,000 Palestinians, according to Gaza health officials, who do not distinguish between fighters and civilians.

Saturday’s vote was the second and final one needed to approve a ceasefire and hostage release agreement. Hours earlier on Friday, the security cabinet voted to approve it, overcoming a key hurdle to a deal that US and other diplomats see as the best chance to end the war. Hamas said there were no longer any obstacles to the deal.

Israeli President Isaac Herzog, who has a largely ceremonial role, welcomed the security cabinet’s vote, although he acknowledged the difficulties ahead in implementing the agreement. “I have no illusions – the deal will bring with it great challenges and painful, painful moments,” he said in a statement.

Under the agreement, both sides would begin a six-week truce, during which Israeli forces would withdraw eastward, away from populated areas. Hamas will release 33 hostages who are still in captivity, mostly women and the elderly.

Mr. Lifshitz’s grandfather is among the hostages to be freed in the initial phase of the deal, but the family has no information on his welfare or whether he is still alive. “Preparation for the ceremony and the funeral at the same time is impossible,” he said.

Israel would also release hundreds of Palestinian prisoners, including some serving long sentences for attacks on Israelis. On Friday night, the Israeli government released a list of 95 Palestinian prisoners it said would be among the first to be released on Sunday, including Khalida Jarrara prominent representative in the West Bank under Israeli occupation.

The cease-fire agreement was adopted with 24 ministers voting in favor and eight ministers against, according to an Israeli official who spoke on condition of anonymity. Most of the ministers who voted against the deal belong to two far-right parties that have condemned the deal, the official said.

The truce would be the first since November 2023, when 105 hostages were freed in a week-long ceasefire in exchange for 240 Palestinian prisoners.

But a host of questions overshadowed the celebrations among the hostages’ relatives, Gazans desperate for the war to end and diplomats who have struggled for months to broker a truce. It is unclear what will happen after the first phase of the cease-fire agreement, which was supposed to last 42 days, including whether Israel intends to proceed with the second phase of the agreement and a permanent cease-fire in Gaza, allowing the remaining hostages to return home.

“I’ll be the happiest man in the world to see any of the hostages come back, but there’s also tremendous concern about the second phase,” said Doron Zexer, a prominent campaigner for the release of Israeli-American hostage Edan Alexander.

While the full cabinet met on Friday, early Saturday, Israeli Prime Minister Benjamin Netanyahu was facing internal rebellion from the far-right partners on whom he depends to hold his ruling coalition together.

On Thursday night, one such partner, the hard-line national security minister, Itamar Ben-Gvir, announced that he would resign from the coalition if the government approves the ceasefire agreement. The Minister of Finance, Bezalel Smotrich, also threatened to leave the government if Mr. Netanyahu moved from the first phase of the ceasefire to a permanent one.

Their moves alone would not prevent the initial phase of the Gaza deal from moving forward. But they would create more uncertainty about Israel’s commitment to a long-term ceasefire, as hardliners in the government push for the Israeli military to continue the war and seek the destruction of Hamas.

Also unclear is the plan for post-war Gaza, despite the optimistic claims of outgoing officials in the Biden administration. US Secretary of State, Antony J. Blinken, he told reporters on Thursday that the ceasefire was a “moment of historic opportunity for the region,” creating possibilities for lasting peace, the reconstruction of Gaza, a “credible path to a Palestinian state” and normalized relations between Israel and Saudi Arabia.

But while President Biden said Thursday that he had pushed Mr. Netanyahu to accommodate Palestinian concerns, the Israeli prime minister consistently refused American invitations work towards an eventual Palestinian state.

“He has to find a way to accommodate the legitimate concerns” of the Palestinians, Mr. Biden said in an interview with MSNBC on Thursday. He called Mr. Netanyahu a friend, but added: “We don’t really get along lately.”

Even after negotiators announced a cease-fire agreement, deadly Israeli airstrikes continued in Gaza. Israel’s military said Thursday it had struck about 50 targets across the territory over the previous day, while Gaza officials reported dozens of people killed.

“The cease-fire seems pointless,” Ahmad al-Mashharwi, who took refuge with more than a dozen relatives in a rented house in Gaza City, said in a telephone interview on Friday. “Artillery and airstrikes continue around us, especially in northern Gaza.”

He said conditions in northern Gaza were dire, with soaring prices and shortages of basic goods.

“We can’t afford food or clean water and my children are starving,” Mr al-Mashharwi said. “Everything has been taken away from us – no security, no resources, nothing to help us survive.”

The ceasefire should pave the way for more humanitarian aid to reach Gaza. The World Health Organization said on Friday it hoped aid deliveries would accelerate sharply to between 500 and 600 trucks a day from 40 to 50 a day in recent months and allow the first steps towards rebuilding health services after more than a year of war.

“We will see if there is political will and if obstacles are removed and routes are opened,” said Dr. Rik Peeperkorn, WHO Representative for the Palestinian Territories.

Hundreds of aid trucks carrying food, tents and other supplies have already lined up in Arisha, near the Rafah crossing with Egypt, according to Al Qahera News, Egypt’s state TV channel.

Aid workers also hope the ceasefire will allow for many more medical evacuations. The WHO reported that Israel has authorized the evacuation of 5,405 patients since the start of the war. But the pace of evacuation slowed after Israel closed the Rafah crossing in May. Of the 1,200 patients the WHO said applied for authorization to evacuate during a one-month period in late 2024, Israel accepted the movement of only 29.

It now wants to restart once-regular transfers to hospitals in East Jerusalem and Egypt, as well as access to hospitals abroad.

“This is not a logistical problem,” James Elder, a spokesman for the UN’s children’s agency, told reporters. “It’s a problem of intent.”

Nick Cumming-Bruce contributed reporting from Geneva.