The use of the helipad at the Mater Hospital in Dublin is in doubt.
City planners have raised concerns about the impact on locals, and some are reluctant to extend planning permission for the landing zone.
Planning permission for the helipad was granted three years ago, but as yet it has not been used.
City planners now say they want a fresh noise impact assessment, a detailed plan in case of emergency and a bird management policy in place before they consider extending permission for the landing zone.
City councillor Joe Costello says the current plan could also negatively affect the hospital itself.
He said: "The hospital itself has plans for future expansion and if the helipad is going to be down on the ground level, then those plans would certainly be up in the air."
It is estimated that the use of a helipad at the Mater could save up to nine lives a year.
Former Dublin Lord Mayor, Councillor Nial Ring, says this reason alone means it would be a worthwhile addition to the hospital.
"I have actually no problem with helipad going there," said Mr Ring.
"It's in the running to be a major trauma centre and I think it's only right that people should have access to the Mater Hospital as quickly and as soon as possible."
The hospital said that if the helipad gets the go-ahead, it would be for "life or death use only".