In 1950, Dewey appointed him a justice of the New York Supreme Court to fill the vacancy caused by the death of Samuel Null.
In December 1950, Dewey re-appointed Breitel to the Supreme Court to fill the vacancy caused by the resignation of Ferdinand Pecora.
In November 1973, he was elected on the Republican and Liberal tickets Chief Judge of the Court of Appeals, defeating Democrat Jacob D. Fuchsberg and Conservative James J. Leff.
His successor as Chief Judge was Lawrence H. Cooke, appointed by Governor Hugh L. Carey in 1979.
He had a stroke in September 1990, and two months later entered the Mary Manning Walsh Nursing Home in Manhattan where he died of heart failure the next year, aged 82.