In 1990 he was consecrated Bishop of Cyrene and was appointed Patriarchal Representative of Parthenios III in Athens (1990-1997), whom he accompanied on his missionary travels throughout the African Continent as well as to international Interfaith and Theological Assemblies. In 1997 he was appointed as Patriarchal Vicar of Alexandria by the late Patriarch Petros VII. In September of the same year he was elected Metropolitan of Cameroon. During his tenure there he developed significant missionary activity. He built churches, schools and clinics, discreetly helping many Africans and Greeks. In 2002 ha settled at the Holy Metropolis in Zimbabwe where he established 4 Missionary centres in the capital Harare, a Hellenic Cultural Centre able to accommodate 400 delegates, 2 large Missionary Centres in Malawi, housing Clinics, technical schools and nursery schools. With the assistance of the Greek Parliament he renovated the “Greek Square” (School-Church-Vicarage) in Beira, Mozambique. He also laid the foundations for churches and contributed to the establishment of Hellenic Communities in Botswana and Angola.
On 9th October 2004 he was unanimously elected by the Hierarchs of the Alexandrian Throne as Pope and Patriarch of Alexandria and All Africa. His Enthronement took place on 24th October 2004 at the Holy Church of the Annunciation of the Theotokos in Alexandria, in the presence of many Primate and Representatives of all the Churches, the Cultural and Political Leaders of Greece and Egypt and thousands of Christians. The general missionary activities of His Beatitude, as well as his sweet and gentle character, are the reason for the love of all our African brothers and sisters for him, as well as of the Greeks and Arabs of Egypt and all Africa.