On May 12, 2010, he was proclaimed as the duly elected mayor of Cebu City for the term 2010 to 2013. He was re-elected as Mayor for the term 2013 to 2016. In December 2015, Malacañang ordered a 60-day preventive suspension of Rama for his alleged culpable violation of the Constitution, grave abuse of authority, grave misconduct, and oppression. Rama reported back to his office on February 8, 2016, as the 60-day suspension imposed on him by the Office of the President has ended.