There are 163 flats in the block with one bedroom and 55 with two, with construction expected to take two-and-a-half years to build.
The car park on which it will be built previously served as Unicentre offices, which have recently been converted from offices to flats, the Local Democracy Reporting Service said.
Planners were told the tower block would not “dominate” Preston’s cityscape.
St. Walburge’s Church, which has a spire that rises to 94 metres, would still have the edge as the tallest city landmark.
City council planning officer Patrick Marfleet said: “Whilst it is tall, we don’t think that it’s excessively tall or harmful in terms of its impact on Preston.
“It’s a landmark building that contributes to the skyline, it’s certainly not a dominant feature, in spite of its height.”