The sacrament of ordination to the threefold ministry of bishop, priest, or deacon. Ordinations take place during the Divine Liturgy, with deacons ordained after the consecration of the gifts, priests after the Great Entrance, and bishops after the Little Entrance. The bishop lays hands on the ordinand while the people sing "Axios!" ("He is worthy!"). Through ordination, the Holy Spirit grants the grace needed for ministry. Only men may be ordained, and bishops must be celibate monastics, while priests and deacons may be married before ordination.

The first Orthodox bishop consecrated in America, who united various Orthodox communities under canonical authority. Celebrated on February 27th, Raphael arrived from Syria in 1895 and was consecrated bishop in 1904. He traveled extensively across America, establishing parishes and bringing Orthodox communities together under proper episcopal oversight.