The mayor of Wabana, Bell Island was sworn into the position while he was at hospital in St. John's on Sunday.
Gary Gosine underwent open heart surgery and had a stroke just a few weeks before municipal elections were held across Newfoundland and Labrador on Sept. 24, 2013.
Gosine campaigned from his hospital bed and was re-elected to the position, which he has held since 1997.
Gosine said his swearing-in at the Miller Centre may be a first in the province's history.
"I couldn't get home, they had to get it done in a certain period of time, so they brought everyone over here," Gosine said.
"It was great to have family and friends around, and that's the way I wanted it."
Gosine said he's looking forward to getting out of hospital and back to work.
Gosine expects he get out of hospital within the next month.