[5] He later pursued doctoral studies in hermeneutics at the Greenwich School of Theology in England, with the degree award by North-West University, South Africa, in 2007.

[6] His doctoral thesis was titled "Confident and imaginative: scripture & hermeneutic in the Johannine passion narrative and today" and was undertaken within a post-liberal theological framework.

[6] Perumbalath worked among university students as a staff worker of the Evangelical Union for two years in his home state of Kerala before training for ordination.

On 18 October 2022, the Prime Minister's Office announced that Queen Elizabeth II had accepted Perumbalath's nomination as the next Bishop of Liverpool.

[18] Perumbalath chairs the council of the College of the Resurrection, Mirfield, and serves on the Clergy Discipline Commission of the Church of England.

[26] On 30 January, he announced that he would "retire from active ministry in the Church of England"[27][28] – in practice, he would "step back" with immediate effect, but resign his see at a later date.

[23] He stated that this was caused by the "rush to judgment and my trial by media (be that social or broadcast) has made my position untenable" and that it "is not a resignation occasioned by fault or by any admission of liability".

In November 2023, he was one of 44 Church of England bishops who signed an open letter supporting the use of Prayers of Love and Faith (blessings for same-sex couples) and called for "Guidance being issued without delay that includes the removal of all restrictions on clergy entering same-sex civil marriages, and on bishops ordaining and licensing such clergy.