The Transfiguration Cathedral was the main church of the Perm diocese in the 19th and early 20th centuries. Its history begins in the 16th century, when in 1560, Anika Stroganov founded the Pyskor Monastery on the Kama River. This monastery was one of the richest in the Urals thanks to the support of the famous Stroganov industrialists. However, by the mid-18th century, the monastery had become impoverished. With the formation of the Perm Governorate, Empress Catherine II ordered the monastery to be moved to Perm, giving it a second life. At the new location, the construction of the monastery cells and the St. Stephen's Church began, consecrated in 1798. The cathedral's design was developed in Moscow, presumably by M. F. Kazakov or his students, and refined by the Perm architect G. H. Paulsen.

The Transfiguration Cathedral resembles the Christ the Savior Cathedral in Lipetsk, possibly due to a standard design. It was intended to be the central building of the monastery ensemble, which included the archbishop's residence, a theological seminary, and other structures. The preparation and financing of the cathedral's construction took almost 10 years, from 1789 to 1798. The foundation was laid in 1798, and construction was carried out in several stages. The summer part of the church, the Church of the Transfiguration of the Lord, was completed in 1818 and consecrated in 1819. Then the construction of the 67-meter bell tower began, designed by architects P. T. Vasiliev and P. I. Tamansky, which housed 11 bells from the Pyskor Monastery.

The grand consecration of the cathedral took place in 1832 by Bishop Arkady of Perm. For the decoration of the cathedral, a carved iconostasis was transported from the Pyskor Monastery, made in Yekaterinburg and Moscow. The architectural style of the cathedral corresponds to classicism, with elements of Ural architecture: thick brick walls, metal grilles, and cast-iron doors.

The construction of the cathedral was supported by the residents of the Perm province, who donated money and materials. The cathedral has undergone several reconstructions. In 1853-1854, the first reconstruction was carried out according to the project of G. P. Letuchiy, connecting the bell tower and the cathedral with a gallery. In 1892-1893, A. B. Turchevich added two chapels with bulbous domes.

In 1931, the cathedral was closed for worship and converted into an art gallery. From 1954 to 1958, the building underwent reconstruction, resulting in it becoming three stories high. The expansion project was carried out by N. A. Shvarev. Inside, lecture halls and offices were equipped, and heating and electricity were installed. The exterior appearance of the cathedral changed: trees appeared on the bell tower's spire, and in 1946 it was damaged by fireworks but was restored.

In 1996, discussions began about transferring the cathedral to the Perm diocese. This officially happened in 2011, and in 2012 the building was returned to the Church. The Perm diocese began preparations for reconstruction to restore the cathedral's historical appearance. In 2011, the dismantling of the old dome, worn out by 95%, began. The new dome is made of modern materials and coated with titanium nitride. The external restoration of the facade is nearing completion, crosses have been installed, and the roof and windows have been replaced. Internal restoration will begin after the gallery relocates, and the unique 18th-century iconostasis will be restored.

Next to the cathedral, the church of St. Mitrophan of Voronezh and the chapel of the archbishops' residence have been restored. In this historical center of Perm, there was a necropolis where famous people were buried, but in the 1930s, the cemetery was closed and turned into a zoo. The Transfiguration Cathedral remains an important spiritual and architectural symbol of Perm, its 67-meter bell tower is one of the city's iconic elements. The cathedral will once again become a spiritual center for Perm and the Perm region.