Premasagar was a pastor hailing from the Church of South India who tended rural congregations in the Diocese of Medak in north Telangana until 1961 when he became a seminary teacher at Dornakal and then moving out to Rajahmundry and later Secunderabad in 1972 and taught Old Testament. In 1980, the Church of South India recalled Premasagar to take up ministerial responsibilities and made him general secretary of the Church of South India Synod at its XVIIth session of the held at Tambaram. In 1983, Premasagar became a bishop and subsequently a moderator of the Church of South India Synod for two consecutive bienniums: 1988–1990 and 1990–1992.