He was emotionless in the dock on Wednesday morning as Victoria's Court of Appeal rejected his appeal in a 2-1 decision.
"Cardinal Pell is obviously disappointed with the decision today. However his legal team will thoroughly examine the judgement in order to determine a special leave application to the High Court," his legal team said in a statement on Wednesday.
"While noting the 2-1 split decision, Cardinal Pell maintains his innocence. We thank his many supporters."
The lawyer representing Pell's surviving victim, Vivian Waller, read a statement from her client to reporters.
"I am relieved by the decision of the Court of Appeal," he said in the statement.
"It is four years since I reported to the police. The criminal process has been stressful. The journey has taken me to places that, in my darkest moments, I feared I would not return from," he said.
Pell's surviving victim
I had experienced something terrible as a child, and I wanted some good to come of it.
"After attending the funeral of my childhood friend, the other [victim], I felt a responsibility to come forward ... I felt that I should say what I saw and what had happened to me. I had experienced something terrible as a child, and I wanted some good to come of it."
"Although my faith has taken a battering it is still a part of my life, and part of the lives of my loved ones."
In a short statement, issued several hours after the judgement, the Vatican said it "reiterating its respect for the Australian judicial system".
"As the proceedings continue to develop, the Holy See recalls that the cardinal has always maintained his innocence throughout the judicial process and that it is his right to appeal to the High Court.
"At this time, together with the Church in Australia, the Holy See confirms its closeness to the victims of sexual abuse and its commitment to pursue, through the competent ecclesiastical authorities, those members of the clergy who commit such abuse."
Pell could be stripped of Order of Australia
Prime Minister Scott Morrison told reporters "the courts have done their job".
"They've rendered their verdict ... That's the system of justice in this country and that must be respected," he said.
The Prime Minister said Pell will be stripped of his Order of Australia.
"My understanding is that this [appeal loss] would result in the stripping of the honours that are decided externally to the government."
Asked if it's time for former prime ministers John Howard and Tony Abbott to denounce Pell, Mr Morrison said "that's a matter for them".
Governor General David Hurley confirmed a conviction can see the honour voided, but said that "once all legal proceedings have run their course, the Council for The order of Australia make make a recommendation".
Chief Justice Anne Ferguson and President Chris Maxwell were agreed in their decision, while Justice Mark Weinberg said he would have ordered Pell be acquitted.
"Cardinal Pell was successful in seeking leave to appeal in relation to the first ground — however, by majority, the appeal has been dismissed," Chief Justice Ferguson said.
She added, "Justice Maxwell and I accepted the prosecution's submission that the complainant was a compelling witness, was clearly not a liar, was not a fantasist and was a witness of truth".
Chief Justice Anne Ferguson
The complainant was a compelling witness, was clearly not a liar, was not a fantasist and was a witness of truth.
"We decided that there was nothing about the complainant's evidence or about the opportunity evidence which meant that the jury must have had a doubt about the truth of the complainant's account."
She also stressed Pell should not be seen as a "scapegoat".
"He is not to be made a scapegoat for any perceived failings of the Catholic Church, nor for any failure in relation to child sexual abuse by other clergy."
Sydney barrister Brett Walker SC, who led Pell's appeal, had argued the crimes were "impossible" as Pell's robes were too "heavy" and "cumbersome".
But Chief Justice Ferguson said "we found that the robes were capable of being manoeuvered in a way that might be described as being pulled to one side or pulled apart".
'A joyous moment'
Cheers were heard outside the court at the news.
Campaigner for abuse survivors Chrissie Foster told reporters it was "a joyous moment".
"It sends a message that [victims] will be believed. It's a crime that really is hard to prove because it's one word against the other - always has been. And rape is like that," she said.
Ms Foster has campaigned for justice for survivors of institutional child sexual abuse for many years. Two of her daughters were sexually abused by a Catholic priest, one who has since died.
"Here, we have, today in our court, in Victoria, the Supreme Court, saying - we believe the victim."
Other advocacy groups have also welcomed the news.
"Believing the victim in this case sends a message to so many other victims that what happened to you mattered and will now be more likely to be believed than ever before," a statement by the Blue Knot Foundation said.
"For many survivors a conviction being upheld against a high profile once powerful perpetrator underlines faith in the justice process and the possibility of speaking out."
Senator Cory Bernardi, a devout Catholic who has described himself as a "friend" of Pell said he "hoped in my heart that George Pell wouldn't be convicted of this offence" and the appeal would be successful.
"I hoped that because I think he has been a very strong leader for Australian Catholics and I didn't want to think ill of someone I've had a great deal of respect for," he told Sky News.
"But we have to take comfort that justice has been done ... We don't like to believe ill of our friends but the court has upheld his conviction and we have to accept that."
Citing "irregularities in the evidence" and the fact that there was one dissenting justice, he said "there are some grounds for further appeal".
In a statement from Archbishop Mark Coleridge of the Australian Catholic Bishops' Conference also said it "accept today's judgement".
"The Bishops realise that this has been and remains a most difficult time for survivors of child sexual abuse and those who support them," he said.
"We acknowledge the pain that those abused by clergy have experienced through the long process of the trials and appeal of Cardinal Pell. We also acknowledge that this judgement will be distressing to many people."
Sydney's Catholic Archbishop Anthony Fisher said he would pray and "continue to support survivors of child sexual abuse at the hands of the clergy and other members of the Catholic Church".
"I again say how sorry I am that you were harmed by people you should have been able to trust. I am conscious how you and your loved ones have had to live with the consequences of abuse for a lifetime," he said.
'Unsafe and unsatisfactory'
Three justices heard Pell's appeal over two days in June.
Mr Walker argued three grounds to secure Pell's release or a retrial, including that the verdicts were "unsafe and unsatisfactory".
He was sentenced in March to six years in prison, to serve three years and eight months before becoming eligible for parole.
Evidence from prosecution witnesses showed Pell greeted parishioners after mass, when the offending was said to have occurred, so it was not possible for him to have committed the "atrocious" crime, Mr Walker said in the appeal.
"If [Pell] was at the western door, then the law of physics tells us this is literally, logically impossible for the offending to have occurred according to the complainant's account, and there is no other account," Mr Walker said.
The other of Pell's victims died in 2014, aged 31, from a drug overdose.
The boy's father, who is suing the priest and the Catholic Church, claiming his son's death was linked to his sexual abuse, confirmed on Tuesday he would continue his fight for compensation whether or not Pell was released from jail.
Chris Boyce QC told the appeal justices that the surviving boy, now aged in his 30s, had stood up to "one of the great old-style cross-examinations" with calm, reliable and credible testimony in last year's trial.
"He was a witness of truth," Mr Boyce said.
Those seeking information or support relating to child sexual assault can contact Bravehearts on 1800 272 831 or Blue Knot on 1300 657 380. Lifeline is available 24 hours a day on 13 11 14.
Additional reporting: AAP