Health Secretary Jeremy Hunt has had his decision to reduce services at a major hospital declared unlawful and quashed by the High Court.
Mr Justice Silber ruled Mr Hunt acted outside his powers when he announced casualty and maternity units at Lewisham Hospital would be downgraded.
He said the Secretary of State had breached provisions of the National Health Services Act 2006.
The judge gave him permission to appeal against the decision.
'Incredible day'The challenge was brought by Save Lewisham Hospital and the London Borough of Lewisham.
There were cheers and tears in Court 76 as Mr Justice Silber gave hospital campaigners the news they had hoped for.
He ruled that Jeremy Hunt and the administrator he appointed to South London Healthcare had acted outside their powers when they decided to reduce services at Lewisham hospital.
He ruled that local GPs had not supported the plans and therefore they should not be allowed to go ahead.
He also gave permission for the government to appeal.
Today's ruling comes six months to the day since Jeremy Hunt announced the downgrading of services like the A&E and maternity units at Lewisham.
Campaigners had argued it was being made to suffer because of the failings of the neighbouring South London Healthcare Trust which is £65m in deficit.
This was the first time the Trust Special Administrator regime had ever been used.
Dr Louise Irvine, a local GP who chairs the Save Lewisham Hospital campaign, said: "This is an incredible day.
"We are delighted for every single person who has supported the campaign and those who will now continue to benefit from this extraordinary hospital."
Rosa Curling, a lawyer with solicitors' firm Leigh Day acting for the campaigners, said it was a "tremendous victory".
She said: "This judgment should serve as a warning to the government that, if they try to do this, local communities will fight back to ensure their healthcare services remain in place."
In January Mr Hunt told MPs in the Commons that the cuts were necessary because neighbouring South London Healthcare NHS Trust has been losing more than £1m every week.
A spokesman said Mr Hunt's department was "disappointed by the decision" and would consider the judgment carefully.
He said: "This judgment applies to one aspect of a package of changes which we believe are in the best long-term interests of patients and the public across south-east London.
"We expect to continue other elements of that package of changes, including the dissolution of the South London Healthcare NHS Trust, planned for October 1 - although there are a number of steps to go before that can take place."
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