Katharine Jefferts Schori has taken office as the first female leader anywhere in the Anglican denomination.
Katharine Jefferts Schori called for "healing" and "wholeness"
Bishop Jefferts Schori, 52, became the presiding bishop and primate of the US Episcopal Church at an investiture service in Washington DC.
She was selected in June to lead the 2.3m-strong Church after narrowly winning a vote.
The choice has proven controversial as most other Anglican Churches around the world do not allow women to be bishops.
More than 3,000 well-wishers attended the investiture ceremony at the Washington National Cathedral.
Outgoing Presiding Bishop Frank Griswold gave her the symbol of her authority, the primatial staff.
KATHARINE JEFFERTS SCHORI
Born 1954 in Pensacola, Florida
Consecrated Bishop of Nevada in 2001
Supporter of ordination of gay bishops
Bishop Jefferts Schori said in her homily: "If some in this Church feel wounded by recent decisions, then our salvation, or health, as a body is at some hazard.
"And it becomes the duty of all of us to seek healing and wholeness."
Bishop Jefferts Schori had been raised a Roman Catholic and is a qualified pilot and a graduate in marine biology.
She served as bishop in Nevada for five years before beating six candidates in June to head the Episcopal Church.
Seven conservative US dioceses have already refused to accept her authority.