In 1495, after the death of Metropolitan Jonah of Kiev, Macarius was chosen and ordained in his place by an assembly of hierarchs; Vassian of Vladimir, Luke of Polotsk, Vassian of Turov and Jonah of Lutsk. Papers of blessing were sent from Constantinople by the Patriarch Niphon, confirming the election of Saint Macarius to the metropolitan See of Kiev. On May 1, 1497 Tatars invading Russia killed Metropolitan Macarius of Kiev and All Rus in the village of Strigolovo, at the River Vzhischa, where the saint was conducting divine services. Many of his flock were killed with him, or taken into captivity .
The holy incorrupt relics of Saint Macarius, glorified by God with miracles, rest now at Kiev at the Vladimir cathedral church.