"We are very, very disappointed that the Newcastle council has ignored the advice of ... the police ... Hunter [New England] Health and ... residents," NewWest Community Group's John Dickenson said on Wednesday.

"It's basically a nightclub doubling its size.

"We've lived and seen what it's like. Yes, there have been some improvements to the [venue's] soundproofing, but the problem is people spilling across the road ending up at McDonald's loitering.

"The noise, the vomiting, the urinating, the property damage, the fighting and the complete disturbance of the basic human right we regard as a good night's sleep."

The council on Tuesday approved the venue's plans to expand into a neighbouring building, lifting its capacity from 780 to 1300 persons.

Only two councillors, John Church and Kath Elliott, voted against the expansion.

Mr Dickenson agreed with Cr Elliott's suggestion residents were most concerned with what occurred outside the venue late at night.

"At four [AM] last Sunday, there were six police cars and two ambulances," he said of an incident which occurred after the venue had closed for the night.

"The screaming, yelling and swearing.

"It's like Dodge City - they all come out and want to fight. They don't go home in an orderly manner."

The council approved the plans after an amendment to make "mitigation measures" outlined in the venue's plan of management mandatory for a year, including extra security, a courtesy bus and dedicated pick-up bay.

Mr Dickenson said the measures were "certainly a start" but the proof would be in the pudding.

He described them as "window-dressing" and said the management plan needed to be linked to the liquor license to ensure there were consequences if it was not adhered to.

In response to comments made by Cr Allan Robinson, who compared the plight of residents to his own qualms having to listen to ships tooting their horns living by harbour, Mr Dickenson said he should try "600 [ships] going from nine o'clock to six o'clock in the morning".

"That is an insult," he said.

"That is to me saying [the venue] was here first. Granted, but [520 extra patrons] ... we didn't know that [before moving here].

"Are you telling me I have no rights because I made a decision, like others, to reside in an area that the council has promulgated as a vibrant city? Denying someone sleep, is that what you call good city living?"

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King Street Hotel and Newcastle City Police had been at odds during the development assessment process about crime statistics associated with the venue.

In a submission opposing the expansion, police also wrote that King Street Hotel patrons were responsible for 28 per cent of criminal incidents at the nearby McDonald's between 10pm and 5am in the past five years, including a third of the 54 assaults.

"That means 72% ... have come from other venues," the hotel said in response, adding it would "commit to providing a security guard to work on the corner [of McDonald's] to encourage persons to reduce noise, and anti-social behaviour".

Mr Dickenson said McDonald's needed to improve its operations. The outlet is company-owned, rather than by a franchisee.

McDonald's Australia corporate relations director James Rickards said the outlet had operated 24 hours for more than two decades and after a recent meeting with council and NewWest, the company was "implementing new security measures to help address and reduce potential threats originating from outside the restaurant's influence and control".

They include improving perimeter fencing, a three-month trial of full and partial closure of the car park to deter loitering, an interior refresh and increasing security.

"While we are increasing the presence of our security guards at peak periods, it is important to reiterate they do not have the powers or authority of police," he said.

"Ultimately, the safe and effective disbursement of crowds and responses to anti-social or violent behaviour outside our restaurant and along King Street is a police matter.

"We continue to engage openly and transparently with the council and community regarding the need for a whole-of-community response to help address alcohol-related anti-social behaviour."

King Street Hotel owner Russell Richardson said he was "pleased with the outcome" and "looked forward to working with all parties in the future".

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