Future Patriarch Adrian, born Andrei, was born in Moscow on October 2, 1637. After becoming a monk, he demonstrated piety and virtue, which caught the attention of Patriarch Joachim. In 1678, Joachim appointed him archimandrite of the Chudov Monastery. Under Adrian's leadership, a cathedral was built in honor of Saint Alexius with a chapel dedicated to the Annunciation and a church in honor of the Apostle Andrew the First-Called.

Archimandrite Adrian held a high position in the church hierarchy, and in 1686, Patriarch Joachim appointed him Metropolitan of Kazan and Sviyazhsk. Little is known about his activities in the Kazan Diocese, but he contributed to the decoration of the Annunciation Cathedral and wrote a book on Orthodox traditions.

In the last days of Patriarch Joachim's life, Metropolitan Adrian was his right hand and, after his death, managed the Moscow Diocese while remaining Metropolitan of Kazan and Sviyazhsk. On August 24, 1690, he was elevated to the Patriarchal throne. In his speech during the enthronement, Adrian called for the preservation of the canons and the defense of the Church against heresies. In his letters, he provided spiritual guidance to various classes. He disapproved of Peter I's innovations, such as shaving beards and abandoning national clothing, but supported the useful reforms of the tsar.

Patriarch Adrian sought to influence his flock morally, avoiding external pressure. He issued the "Instruction for the Elders of Priests" and the "Episcopal Instruction to Newly Appointed Priests." Adrian also wrote services for saints and letters, including to Peter I.

Adrian's spiritual guidance was reflected in his will, where he urged the preservation of the Orthodox faith and the defense of the Church. In 1698, he blessed the canonization of Euphrosinia of Suzdal.

In his last years, the patriarch lived in the Perervinsky Monastery, where he died on October 15 or 16, 1700. His activities as patriarch were significant; although he reluctantly accepted Peter I's reforms, he recognized the necessity of some changes in church governance.

Relations with Peter I soured after Adrian refused to shave the tsar's wife, Evdokia Lopukhina. During the Streltsy Uprising, he interceded for those executed, but his pleas were rejected. However, he supported the tsar in educational matters, which led to the establishment of the Academy of Sciences in 1724.

Some contemporaries and historians criticized Adrian for his attitude towards Peter I's anti-clerical policies. Peter I did not attend his funeral, which was an unprecedented event. Patriarch Adrian was buried in the Assumption Cathedral of the Moscow Kremlin.