The Wesleyan Methodist Missionaries from England began working since 1879 in the Districts of Hyderabad, Medak, Nizamabad, Karimnagar and Nalgonda.
As a result of their mission work churches were established along with Schools and Hospitals.
After the formation of Church of South India in the year 1947, Karimnagar and Nalgonda areas from Medak were annexed to the Dornakal Diocese.
The CSI Wesley Cathedral church was built by the missionaries in the year 1978.
Wesley Cathedral has been completely renovated and rededicated in 2011.