Bishop Heather Cook became Maryland's first female Episcopalian bishop after being elected in September.
Police now say she'll face charges for the vehicular manslaughter of Tom Palermo, 41.
He was hit by a car that failed to stop in Baltimore on December 27.
The Maryland diocese previously said Bishop Cook had left the scene but returned within 20 minutes and admitted "responsibility for her actions".
Prosecutors say she was three times the state's legal alcohol limit when she was tested by police.
An investigation has also been launched by the national Episcopal Church.
The family of the dead cyclist said they "support the prosecutor's efforts to hold Bishop Heather Cook accountable for her actions to the fullest extent of the law".
Bishop Cook pled guilty to drink driving in 2010.