Macarius took monastic vows in 1861, being ordained a hieromonk (monastic priest). In 1883, he was consecrated as Bishop of Biysk, being later appointed Bishop of Tomsk and Semipalatinsk in 1891. He also later served as Bishop and Archbishop of Tomsk and Barnaul, and Archbishop of Tomsk and Altay. In 1912, he was elected by the Holy Synod as Metropolitan of Moscow and Kolomna.