From archimandrite to metropolitan
Before his elevation to the episcopate, Macarius governed the Holy Trinity monastery in Vilnius as its archimandrite. When the metropolitan See of Kiev fell vacant on the death of Metropolitan Jonah, an assembly of hierarchs — named in the synaxarion as Vassian of Vladimir, Luke of Polotsk, Vassian of Turov, and Jonah of Lutsk — chose and ordained him to fill it in 1495.
His election was confirmed from Constantinople, where the Patriarch Niphon sent papers of blessing recognizing Macarius as Metropolitan of Kiev. He thus took up the leadership of the Orthodox flock in the western lands of Rus during an unsettled time.