The United States House of Representatives voted Nancy Pelosi as Speaker on Thursday.

Pelosi, 78, starts her second tenure of leading the House after eight years of Republicans controlling the chamber. She received 220 votes out of a possible 430. Only 15 members of the party voted against her on the House floor.

Pelosi is the first woman to serve as Speaker. After her Democratic Party gained a net 40 GOP-held seats in November, she struck a series of deals to stave off rebellion within her party. Some Democrats who wanted a fresh leadership altogether  opposed opposed the idea of having Pelosi return as Speaker, but she secured enough votes to lead the House again.

Pelosi has represented the San Francisco area for more than 30 years. She has led House Democrats for more than 16 of those years.

Her first stint as Speaker  lasted from 2007 to 2011 when she oversaw the House’s response to the 2008 financial crisis and spearheaded the chamber’s passage of the Affordable Care Act.