H.G Kayalath Dr. Stephanos Mar Theodosius was the first Diocesan Metropolitan. He became the Metropolitan of the newly formed Calcutta diocese in 1979 which was bifurcated from the diocese.
Today
The present diocese was formed on 1979 and the Diocesan Metropolitan was the late H.G. Zachariah Mar Dionysius. Diocese of Madras includes the territorial area of Tamil Nadu, and Andaman islands in India, and Sri Lanka
Since the demise of H.G. Mar Dionysius in 1997, H.G. Dr. Yakob Mar Irenaios Metropolitan led the diocese. The Diocese celebrated its Silver Jubilee in 2004 and launched several charitable and social development programmes. Territorial and institutional growth caused the Diocese to be divided into three Madras, Bangalore and Brahmavar Dioceses. The diocese has 64 independent parishes and many more congregations including 9 cathedrals. Sixty-five priests serve the parishioners, including 6 Cor-episcopas, 1 Cor-episcopa ramban, 4 rambans, and 4 retirees.
The diocese has a charitable institution called Snehabhavan, which is a guidance centre for patients undergoing treatment in Christian Medical College, Vellore.
This diocese includes non-Malayalee communities consisting of Tamil Christians with Tamil Priests, worshiping in Tamil language in Salem, Dindigul and Sri Lanka. The diocese also runs 2 guesthouses in Chennai city for youngsters who came to study as well as work.