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Fr Hilarion was approved by the Bishop's Sobor meeting at Mansonville, Quebec in 1983, and Metropolitan Philaret (Voznesensky) suggested that he be appointed Bishop of Manhattan, a vicar bishop of the Diocese of New York and Eastern America. On 10 December 1984, at the young age of 36, Fr Hilarion was consecrated a [[bishop]] by [[Metropolitan]] [[Philaret (Voznesensky) of New York|Philaret of New York]] and nine other bishops (Abps [[Seraphim (Ivanov) of Chicago|Seraphim]], [[Antony (sinkevich) of Los Angeles|Antony]], [[Vitaly (Ustinov) of Montreal|Vitaly]], [[Laurus (Skurla) of Syracuse and Holy Trinity|Laurus]], [[Paul (Pavlov) of Sydney|Paul]], and Bps [[Gregory (Grabbe) of Washington|Gregory]], [[Mark (Arndt) of Berlin|Mark]], [[Alypy (Gamanovich) of Cleveland|Alypy]]) at the Synodal Cathedral in New York City. He was appointed to the [[see]] of Manhattan and charged with overseeing the [[parish]]es in Pennsylvania and the Eastern American diocese. In 1987, he was named deputy secretary for the Synod of Bishops. In 1995, Bishop Hilarion was transferred to the See of Washington while retaining his residence in New York. During his time as Vicar of the Eastern American Diocese, he was noted for frequent visits to parishes and accessibility to the faithful.
The Diocese of Australia and New Zealand was experiencing turmoil, and had not had a ruling bishop for five years; hence in June 1996, recognising his pastoral gifts, he was transferred to the [[Diocese of Australia and New Zealand (ROCOR)|Diocese of Australia and New Zealand]] (which was experiencing some problems at that stage) and raised to the rank of [[archbishop]]. Abp Hilarion set establishing the Property Trust as an Act of the New South Wales Parliament, and then rectifying the shortage of priests and beginning missionary work, generally strengthening the diocese and its church life. In 2003 he was awarded the honour of wearing a diamond [[cross]] on his [[klobuk]]. He continued his accessibility to the faithful in his new diocese, including missions in Korea, China and Indonesia. He was the first hierarch of ROCOR to visit China since [[St John (Maximovitch) the Wonderworker|St John of Shanghai and San Francisco]]'s departure after World War II.
Upon Metr. Laurus's death, Abp. Hilarion was appointed as the temporary head of the ROCOR Synod. To his dismay, on [[May 12]], 2008, Archbishop Hilarion was elected and elevated as the new Metropolitan of ROCOR, having received all but one vote (his own). As First Hierarch, he convenes meetings of the synod (3-4 times each year), meetings of the Council of Bishops, and represents the ROCOR at the Moscow Patriarchate when bishops convene there. In addition, he remains ruling bishop of the diocese of Australia and New Zealand, in addition to also being ruling bishop of the Eastern American diocese.
