Flint Community Hospital could be closed under plans by Betsi Cadwaladr University Health Board (BCUHB) to reorganise its services in north Wales.
Campaigners joined a protest march from the hospital to attend the public meeting at the town hall.
In a statement BCUHB said retaining the status quo was "not an option".
The health board, which predicts a financial shortfall of Â£64.6m this year, revealed details of its proposed shake-up in July.
Under plans being considered Blaenau Ffestiniog community hospital could also close and minor injury accident departments may shut at other locations.
Neo-natal intensive care may also be transferred over the border to England as part of the proposed shake-up.
Shortly after the plans were made public GPs in the area revealed their concerns about the effects of proposed cuts on community services.
Mark Scriven, the health board's medical director, said there was sound reasoning behind the proposals to close Flint hospital.
"The thinking generally about the problems we're trying to address in these proposals with community hospitals is that some of them are very old, and they have poor fabric," he told BBC Radio Wales.
He said it was not just the furnishings that were not up to scratch, the physical space did not suit modern health care.
"A lot of them, and the services they provide, are underused, and certainly the minor injuries unit at Flint hospital is underused, which is important because it doesn't allow the nurses running it to maintain their experience according to their professional bodies," added Mr Scriven.
In response, Jack Reece, chairman of the Save Our Cottage Hospital Campaign, said Flint hospital was well used.
Speaking at Tuesday protest, he added: "They've closed us, they took beds away from us. We've had 18 going down to 14, going down to 12, 10.
"They're taking away our clinics from there. They have systematically dropped the services from this town."
Mr Reece described BCUHB's plans as a new version of old proposals by the Flintshire Health Board which had already been rejected by the Welsh government.
Explaining the reasons behind its proposed shake-up, BCUHB said it was clear that it could not afford to stand still.
"The status quo is not an option," the board said.
"The proposals we are now making are intended to change the way in which services are provided and where they are provided to ensure patient safety and meet quality standards.
"The proposals will allow us to attract and retain the professional clinical staff we need and control our costs when public finances are decreasing."
BCUHB said its consultation exercise would run until 28 October, and it would also take account of the views of the community health council and any views they have heard from the public before making decisions.
Any changes would start in early 2013, it said.
More than 1,000 campaigners trying to save a north Wales community hospital from closure have marched to a health board consultation meeting.