 He received his episcopal consecration on the following 4 May from Pius XII himself, with Archbishop Giuseppe Migone and Bishop Alfonso de Romanis, OSA, in the Sistine Chapel.Confalonieri became Secretary of the Sacred Congregation for Seminaries and Universities on 25 January 1950, and later Titular Archbishop of Nicopolis ad Nestum on 22 February of that same year.Pope John XXIII created him Cardinal-Priest of "S. Agnese fuori le mura" in the consistory of 15 December 1958, and Confalonieri was later appointed Archpriest of the Liberian Basilica on 16 November 1959.