From general to patriarch
Before his episcopacy Ephraim pursued a distinguished secular career in the service of the Eastern Roman state. Sources record him as a Syrian, born at Amida (modern Diyarbakir) in Mesopotamia, who served under the emperors Anastasius I and Justin I and rose to the rank of Count of the East, the senior official responsible for the eastern frontier provinces. The synaxarion remembers him as a man marked by virtue, piety, and compassion for the poor.
His turn to the Church followed the 526 earthquake. Entrusted by the emperor with restoring Antioch, he won the confidence of clergy and people, and upon the death of Patriarch Euphrasius in the disaster he was raised to the patriarchal throne in 527. The tradition relates that a bishop encountered during the rebuilding foretold his election and urged him to persevere in charity and in the defense of the faith.