From 1878 to 1883, Vasily studied at the Pskov Theological Seminary. In 1888, at the age of 23, he graduated from the St. Petersburg Theological Academy as a layman. He returned to the Pskov Seminary and became an instructor of Moral and Dogmatic Theology. In 1891, at the age of 26, he took monastic vows and was given the name Tikhon in honor of St. Tikhon of Zadonsk. Tikhon was consecrated Bishop of Lublin on October 19, 1897. On September 14, 1898, Bishop Tikhon was made Bishop of the Aleutians and Alaska. As head of the Orthodox Church in America he reorganized the diocesan and changed its name from "Diocese of the Aleutians and Alaska" to "Diocese of the Aleutians and North America" in 1900. While living in the United States Archbishop Tikhon was made a citizen of the United States.
He had two vicar bishops in the United States: Bishop Innocent (Pustynsky) in Alaska, and St. Raphael (Hawaweeny) in Brooklyn. In June of 1905, St. Tikhon gave his blessing for the establishment of St. Tikhon's Monastery in Pennsylvania. On May 22, 1901, he blessed the cornerstone for St. Nicholas Cathedral in New York, New York, and was also involved in establishing other churches in North America. On November 9, 1902, he consecrated the church of St. Nicholas in Brooklyn for the Syrian Orthodox immigrants. Two weeks later, he consecrated St. Nicholas Cathedral in New York.
In 1907, he returned to Russia, and was appointed Bishop of Yaroslavl. St. Tikhon was transferred to Vilnius, Lithuania on December 22, 1913. On June 21, 1917, he was elected the ruling bishop of the Moscow by the Diocesan Congress of clergy and laity. On August 15, 1917, Archbishop Tikhon was raised to the dignity of Metropolitan of Moscow. On November 5 of the same year, after an election as one of the three candidates for the Patriarchate Metropolitan Vladimir of Kiev announced that Metropolitan Tikhon had been selected for the position after a drawing of lots as the new Patriarch of the Russian Orthodox Church.
After the establishment of the Communist regime the Patriarch was viewed as saboteur for which he was imprisoned from April 1922 until June 1923. In 1924 he fell ill and was hospitalized. On Sunday, March 23, 1925, he served his last Divine Liturgy, and died two days later. According to the Old Style Calendar — still in use by some Orthodox Church jurisdictions — he died on April 7.