Greek lawmakers on Friday ratified a landmark name change deal with neighbouring Macedonia, handing Prime Minister Alexis Tsipras a diplomatic triumph and bucking street protests to end one of the world's most stubborn diplomatic disputes.

A narrow majority of 153 MPs in the 300-seat chamber approved the deal, with several independent lawmakers supporting Tsipras' leftist Syriza party.

"With this agreement, Greece regains... its history, its symbols, its tradition," Tsipras told the chamber ahead of the vote during the two-day debate, calling an end to "thirty years of hypocrisy".

He stressed that Macedonia will henceforth "become a friend, an ally, a supporter for cooperation, peace and security in the area."

Macedonia's parliament on January 11 backed a constitutional revision to change the name to the Republic of North Macedonia, but for the deal to go through, it had to be approved by Greek MPs.

Since 1991, Athens has objected to its neighbour being called Macedonia because Greece has a northern province of the same name. In ancient times it was the cradle of Alexander the Great's empire, a source of intense pride for Greeks.

To make the UN-sponsored agreement final, Greece must also ratify a protocol approving Macedonia's membership of the Western military alliance NATO. This is expected to take place next month.

Protests have been held in both countries against the agreement -- some of them violent - and lawmakers in Greece have reported threats and arson attacks against their homes.

A few dozen protesters gathered outside parliament on Friday.

A poll released by SKAI TV on Thursday night found 62 percent of respondents oppose the deal, with 27 percent in favour.

A week earlier, another poll in Proto Thema weekly had found 66 percent in opposition.

'New page in history'

Leftist Prime Minister Alexis Tsipras was closely involved in brokering the June deal with Macedonia counterpart Zoran Zaev. Both have staked their political careers on its outcome.

Anti-Tsipras daily Ta Nea on Friday said the deal was the result of a "painful compromise" and was full of "pitfalls".

In addition to normalising relations between the two countries, implementation of the agreement will open the door for Macedonia to join the European Union and NATO, hitherto blocked by Athens' veto.

But in Greece, its neighbour's name continues to fuel controversy in politics and society, ahead of parliamentary elections scheduled for October.

Critics say the agreement - which drops Greece's objections to an official Macedonian language and identity - opens the way for possible cultural usurpation and trade disputes.

Main opposition leader Kyriakos Mitsotakis of the conservative New Democracy party said the agreement "creates new problems" and "awakens nationalism".

"Your foreign policy is superficial and ignorant... you should be ashamed," he told the government.

But Tsipras insisted Thursday: "We never had a Macedonian language. Alexander the Great spoke Greek."

"Are you afraid of a state that does not even have two percent of our (military) capability and not even six percent of our economic output?," former foreign minister Nikos Kotzias, a signatory of the agreement, asked parliament on Thursday.

On Sunday, clashes between police and masked protesters left 40 people injured as tens of thousands demonstrated in Athens against the name change.

The government blamed far-right extremists and the neo-Nazi Golden Dawn party for the violence.

Symbols and statues

One of the causes of the dispute was Greece's longstanding concern that Macedonia sought to usurp the heritage of Alexander the Great, one of history's greatest conquerors and a hero-figure to most Greeks today.

The previous nationalist government in Skopje built giant statues to Alexander and his father Philip, and commissioned books that blurred the Greek identity of ancient Macedonians.

Under the deal signed at the Prespes Lakes district in June, the monuments will stay in place, but Skopje is obliged to add plaques to explain their Hellenistic identity.

The 20-article agreement states that within six months Macedonia "shall review the status of monuments, public buildings and infrastructure on its territory... to ensure respect for (ancient Hellenic) patrimony."

Authorities must also remove all public imagery of the Sun of Vergina, an ancient symbol associated with Alexander's family that adorned Macedonia's first post-independence flag until 1995.

No reference is made to the present modified flag, a stylised yellow sun on a red field with just eight rays instead of the Vergina Sun's sixteen.

Documents and language

The nationality of the renamed state's citizens will remain "Macedonian". Greece will have some adjustments to do here, having called its neighbours "Skopjans" for the last 27 years.

However, official travel documents are henceforth supposed to say "Macedonian/citizen of the Republic of North Macedonia".

The official language - held by Greeks to be a Bulgarian dialect - will be listed as Macedonian as well.

But to underscore the difference from the Greek spoken by the ancient Macedonians, before the arrival of the Slavs from the 6th century onwards, the agreement specifies that the modern Macedonian language belongs to "the group of south Slavic languages."

Passing through the hands of the Romans, the Byzantines, the Bulgars, the Serbs and the Ottomans, Macedonia had become a melting pot of cultures by the early 20th century.

Initially called Southern Serbia and Vardar Banovina after the Balkan Wars, Macedonia became one of the six republics of the Yugoslav federation created by Tito.

When it seceded from the crumbling Yugoslav state in 1991, it kept the name Republic of Macedonia - already part of its identity for four decades, triggering the row with Greece that still endures today.

Country codes for licence plates will change to NM or NMK, but for all other purposes - such as sports events - they will remain MK and MKD.

Food and wine

A perhaps trickier challenge lies in establishing a common policy on the designation of local products, some of which have borne the name "Macedonian" in the Greek province of Macedonia for decades.

This includes Macedonian wine but also Macedonian halva, a flour-based sweet of Turkish origin popular on both sides of the border.

Under the agreement, Athens and Skopje pledge to "encourage" their respective business communities to "reach mutually accepted solutions" to this trademark conundrum.

The process is likely to take years.