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In the Orthodox church the episcopate refers either to the status of a bishop or the collective body of all the bishops. When the collective body of bishops is referenced the word often used to describe it is episcopacy. Only a properly consecrated man in the line of succession dating back to the Holy Apostles can be an Orthodox bishop, commonly referred to as apostolic succession. Consecration to the episcopate must be within the “One Holy Catholic and Apostolic Church.”

The words episcopate, episcopacy, and episcopal are derived from the Greek επίσκοπος, transliterated epískopos, which literally means "overseer." The word, however, is used in religious contexts to refer to a bishop who usually is the leader of a diocese. Some bishops as members of the episcopate may be assistants to a diocesan bishop, called variously as auxiliary, vicar, or titular bishops.

The episcopate, bishop, over the diocese is both sacramental and political. As well as performing ordinations and consecrations, the bishop supervises the clergy of the diocese and represents the diocese both secularly and in the hierarchy of church governance.

Bishops may be subject to higher ranking bishops variously called archbishops, metropolitans, and/or patriarchs, depending upon the tradition. They also meet in councils or synods. These synods, subject to presidency by higher ranking bishops, may govern the dioceses that are represented in the council, though the synod may also be purely advisory.

The Orthodox Church continues the conciliar idea of episcopal government. The autocephalous primates in the Orthodox Church are seen as collectively gathering around Christ, with other archbishops and bishops gathering around them, and so forth, in a model called "conciliar hierarchy." This is based in part on the vision in the Book of Revelation of the twenty-four elders gathered around the throne of Christ, who are believed to represent the twelve patriarchs of Israel and the twelve apostles of Jesus Christ. There is no single patriarch in the Orthodox Church with exclusive authority comparable to the Pope in Rome.

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