The proposal by Sen. Nicholas Scutari, D-Linden, would allow patients with certain chronic and terminal illnesses to grow six marijuana plants or have marijuana grown for them at an authorized treatment center.
"If medical marijuana can ease some of the suffering of a patient who's dying from a chronic, severe or terminal disease, state government should not stand in the way of that relief," Scutari said after the vote.
The 22-16 Senate vote marked the first time the bill had advanced in the Legislature. It now goes to the New Jersey Assembly, where its fate is uncertain.
If the proposal becomes law, New Jersey would become the 14th state to allow medical marijuana.
Advocates say medicinal marijuana has been shown to alleviate pain and nausea in patients suffering from cancer, glaucoma, multiple sclerosis, AIDS and HIV - the virus that causes AIDS - when other drugs fail.
"For the sake of our most vulnerable, our sick and dying patients struggling for relief, now is the time for New Jersey to join the growing list of states allowing compassionate use of medical marijuana," said Roseanne Scotti of the Drug Policy Alliance, a group that supports the bill.
Critics say the bill would promote illegal drug use.
Sen. Gerald Cardinale, R-Cresskill, said he opposed it because of unanswered questions about how authorities would oversee marijuana growing inside patients' homes.
Most of the states that allow it have done so through ballot referendums. In New Jersey, the law must be changed by the Legislature.
States where medical marijuana is legal are: Alaska, California, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont and Washington.
Only Hawaii, Vermont, Rhode Island and New Mexico legislatures passed bills to legalize medical marijuana; the other states did so through voter referendum.
Scotti said in New Jersey, polls show residents support the legislation by numbers as high as 86 percent.
During a 2006 hearing on the bill, celebrity Montel Williams told New Jersey lawmakers that marijuana helps alleviate chronic knee and foot pain brought on by multiple sclerosis.
Williams, a registered medical marijuana user in California, said he became an activist pushing for medical marijuana laws after being stopped at a Detroit airport by an Alcohol Tobacco and Firearms officer for carrying drug paraphernalia. The charge was later dropped.
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