Franchetti -- who was confirmed by a vote of 95-1 -- has been performing the job in an acting capacity since August due to a single Republican senator's opposition to Pentagon abortion access policy.
She has served on a series of surface vessels, commanding a guided missile destroyer, a destroyer squadron and two carrier strike groups.
Franchetti was deputy commander of US naval forces in Europe and as well as in Africa, and deputy chief of naval operations for warfighting development. She became vice chief of naval operations -- the service's number two position -- in September 2022.
The Senate also approved the nomination of General David Allvin to head the US Air Force by a vote of 95-1, filling a gap created when the service's top officer became chairman of the Joint Chiefs of Staff.
Allvin -- a pilot with more than 4,600 flight hours, including 100 in combat -- previously served as vice chief of staff of the Air Force.
Lawmakers usually approve military nominations quickly through unanimous consent, but Senator Tommy Tuberville has blocked that option for months, leaving the Senate with the time consuming option of holding votes on individual nominees.
Harming 'operational readiness'
Tuberville -- a Republican from Alabama -- has been stalling the nominations to protest Pentagon policies allowing service members seeking reproductive health care including abortions that is unavailable where they are stationed to receive travel allowances and take administrative absences.
The Defense Department issued the policies earlier this year in response to the 2022 Supreme Court decision striking down the nationwide right to abortion.
The White House took aim Thursday at Tuberville's delay of the nominations, saying it is harming readiness.
"It's beyond ridiculous that this one senator is having this kind of an impact on our operational readiness," National Security Council spokesman John Kirby said, noting that it is also affecting officers' families.
"Folks can't get schools for their kids, can't buy or rent houses, you know, don't know where they're going to be living next. It's absolutely ridiculous," he said.
The Pentagon said Monday that 378 nominees for general and flag officer positions remained in limbo, but the deadlock could be broken by a resolution sponsored by Democratic Senator Jack Reed.
It would allow military nominations to be considered en masse during the 118th Congress -- which lasts through the end of next year -- with the exception of officers selected to serve on the Joint Chiefs of Staff or as the heads of combatant commands.