The seven sacraments of our Church are Holy Baptism, Chrismation or Confirmation, Holy Eucharist (Divine Liturgy or Holy Qurbana), Holy Matrimony, Ordination, Confession or Penance, and Anointing of the Sick (Thailabhishekam).

The Catholicos of the East and Malankara Metropolitan, who resides at Devalokam Aramana in Kottayam (Kerala, India) is the supreme head and the leader of the Indian Orthodox Church. His Holiness the Catholicos presides over the Malankara Association, Malankara Association Managing Committee and the Holy Episcopal Synod. His Holiness is the custodian of all assets of the Church. Below him is the Catholicos-designate, who also resides at Devalokam Aramana in Kottayam and responsible for a Diocese of which he is the Metropolitan. The Holy Episcopal Synod (comprising all the Metropolitans including the Catholicos) is responsible for faith, order, and discipline of the Church. Each member of the Episcopal Synod is a vice president of all governing bodies of the Church. A Metropolitan of a diocese governs a diocese representing the Malankara Metropolitan. The Malankara Association Managing Committee is the Governing body of the Church with representation from all dioceses. The Malankara Association is the general body of the Indian Orthodox Church with representation from all parishes and responsible for electing the Managing Committee members, Malankara Metropolitan, Catholicos, Priest-Trustee, Lay-Trustee, Catholicos-designate, and all Bishops of the Church.

Major Orders include the following:

• Bishop (Episcopos)
• Priest (Kohano)
• Deacon (Shomshono)

Minor Orders include:

• Remban (Monk)
• Sub-deacon
• Reader (Korooyo)
• Acolyte (Altar assistant)