Musk may also face fresh lawsuits on the deal, which would be the largest in American corporate history.
Shareholders had first approved the bumper pay packet in 2018.
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“This thing is not over,” said Brian Quinn, a professor at Boston College Law School.
The Delaware judge will scrutinise the vote and require Tesla to prove the process was not coerced or improperly influenced by Musk, Professor Quinn said.
The judge had criticised Tesla’s board fore being “beholden” to Musk, saying the plan was proposed by a “conflicted board” with “close personal and financial ties” to its top executive.
Shareholders also approved a proposal to move the company’s legal home to Texas from Delaware.
They also backed other proposals, including the re-election of two board members, Musk’s brother Kimbal Musk and James Murdoch, son of media mogul Rupert Murdoch.
Shareholders did increase the level of investor control by passing proposals in favour of shortening board terms to one year and lowering voting requirements for proposals to a simple majority, despite board opposition to both.
Tesla did not disclose the voting tallies, which are expected to be revealed in coming days.
At least a half-million viewers watched the meeting on the livestream on X, which Musk also owns, and about 40,000 watched on YouTube.
Tesla’s share price has dropped about 55% from its 2021 peak as electric vehicle sales have slowed.