Standing on top of a late Roman church, the cathedral, reconstructed in the 1970s and 1980s, follows a cross-domed plan with a bell tower and a triple apse.

The Roman basilica may have remained in use by the local congregation during the First Bulgarian Empire, though it was no longer active by the time the construction of the current church began.

The compound suffered large-scale damage caused by a fire, which necessitated the church's reconstruction in middle of the 14th century, perhaps during the rule of Tsar Ivan Alexander of Bulgaria (r. 1331–71).

The earliest reference to the church tells of the transfer of Saint Michael the Warrior's relics from the Potuka fortress to the Patriarchal Cathedral on the order of Tsar Kaloyan (r.

[3] The housing of a warrior saint's relics in the Patriarchal Cathedral signifies the incessant warfare against Byzantines and Latins that dominated Kaloyan's reign.

[6] The Patriarchal Cathedral of the Holy Ascension of God is located on top of the Tsarevets hill, overlooking the modern city of Veliko Tarnovo.

The church was part of a group of buildings which constituted the seat of the Bulgarian Patriarchate and acted as the city and the country's main cathedral.

It is unclear whether the church housed a synthronon (stone benches for the clergy) in the apse, as there are doubts that its remains may actually be part of the older basilica.

While the facades were decorated with arches and ceramic tiles, the interior floor mosaics were made of white, yellow and pink marble as well as semi-precious gemstones like sapphire and porphyry.

During the church's 20th-century reconstruction, its interior was repainted by artist Teofan Sokerov, who depicted important moments of medieval Bulgarian history in a modernist style.