The tsar was to choose his bride from a bride-show of hundreds of daughters of the nobility, who were summoned to the imperial court for selection.

The bridal selection of Alexis I was managed by Boris Morozov, and gathered together almost two hundred daughters of the nobility, among them Maria Miloslavskaya.

She had the support of Boris Morozov, who intended to marry her sister Anna Miloslavskaya, and hoped that Alexis I would choose Maria, which would make him the brother-in-law of the tsar.

During the selection ceremony, however, the tsar chose Euphemia Fedorovna Vsevolozhskaya by presenting her with a handkerchief and a ring as a symbol of their engagement.

Upon the advice of the tsar's confessor, the wedding was a very somber ceremony, excluding all music, games and other festivities except for religious singing, to follow the wish of the famously ascetic Patriarch Joseph of Moscow.

She engaged in charity public donations to the Moscow city hospitals for the poor sick and disabled, and supported the work of Fyodor Rtishchev.

They had thirteen children (five sons and eight daughters) in twenty-one years of marriage, and she died only weeks after her thirteenth childbirth.