An extra 150 beds and a new hospital wing would be created, with construction set to begin in its first term.
The revamp includes more operating theatres, greater intensive care capacity, extra car parks and an updated emergency and trauma centre.
The hospital pledge is the Coalition's single biggest election promise and Liberal Leader Matthew Guy expected it would take more than five years to complete.
Liberal health spokeswoman and former midwife Georgie Crozier used to work at The Alfred and described the facilities as "crumbling".
"A hospital that is not fit for purpose, it is not up to scratch in the 21st century. That is Labor's failure, that is Daniel Andrews' failure," she told reporters on Saturday.
Jason Hennessey attended the press conference with the Liberal leadership and explained his wife Kylie, who had a brain tumour, had to travel to Adelaide to get a specialised MRI scan because the machine at the Alfred was broken.
Mr Hennessey said there was a three month wait before his wife could get the scan at another Melbourne hospital.
"If we had to wait three months, my wife would have died," he told reporters.
Mr Guy reiterated his health spending plan was possible because if elected he would shelve stage one of the $35 billion Suburban Rail Loop project from Box Hill to Cheltenham.
So far the Coalition has committed funds to more than 20 hospitals, $125 million to triple zero and plans to recruit an extra 40,000 nurses.
Heath has become the dominant issue in the 2022 campaign, after pressures on the system were highlighted through the pandemic.
On Saturday, Labor promised to roll out 1,500 machines in public spaces offering free period products, if re-elected.
The $23 million plan would see dispensers installed at libraries, trains stations, courts, public hospitals and other areas.
Premier Daniel Andrews said the measure would provide cost of living relief.
"This matters to women and girls right across our state. It's a simple thing, but it will make a really significant difference," he told reporters.
Some 4 million products have already been distributed after the government installed dispensers at public schools.
Labor's health announcements include committing to building or revamping more than ten hospitals, including rebuilding the Royal Women's and Royal Melbourne hospitals in Ardern, and training more than 20,000 nurses.
Mr Andrews ruled out reports Labor was exploring options for a four day working week in Victoria.
The Coalition confirmed it will preference the Greens over Labor at the November 26 poll, which it believes could mean the government may lose up to three seats.
Most of its how-to-vote cards put Labor last but Mr Guy said there would be exception to that rule depending on circumstances in a particular seat, for example if a candidate has far-right sympathies.
Labor campaign spokesman Danny Pearson claimed Mr Guy missed an opportunity to condemn extremist views.
"He needs to act on this immediately and send a very clear signal that these extremists have no role to play in this election," Mr Pearson said.
Meanwhile, more single-use soft plastics would be phased out of Victorian supermarkets under a strategy released by the Greens.
It would ban fruit and vegetables wrapped in plastic, encourage customers to bring in their own containers for deli items and increase recycling capacity through a $150 million funding boost.
It comes after the nation's largest soft plastic recycling program, REDcycle, was suspended over concerns items were not being properly processed, posing environmental and safety risks.
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