Billionaire brothers Simon and David Reuben are behind the 42-storey skyscraper which will include 222 flats, a boutique hotel and a roof top sky bar.
Cladding of the building will be a mixture of midnight blue ceramic panels with white porcelain columns extending up to the top floor.
Westminster Council’s planning and city development committee gave the go ahead to the initial design and land use proposals last night.
This paves the way for the developer to work up more detailed aspects of the site which will be considered later in the year.
Initial agreement was also given to three other buildings around the site: a 17 storey office building, including shopping space; a 21 storey building containing 201 residential flats, retail and community uses; and a 15 storey building containing 119 residential properties, retail and medical faculties.
Planning committee chairman Cllr Alastair Moss said: “We have given our approval to certain key aspects of these detailed plans including the height and design of the buildings and the public realm between them.
“The scheme has the potential to transform this part of Westminster, from what has previously been an industrial area into an exciting hub of residential, retail and leisure facilities.
“The architectural designs are impressive. They could deliver an iconic addition to London’s skyline and serve as a focal point for Paddington and the surrounding area.
“There is a good mix of housing and employment-generating uses in the plans and it is a sign of great confidence that residential and economic development continues in Westminster.
“We will now wait for further details of the environmental impact and the other planning benefits to be provided as part of the development before a final planning judgement is made.”