A medieval stone church once stood in Ålems kyrkby, with a tall nave and a narrower, straight-ended chancel, its interior covered by vaulting carried on pillars, and its bells hung in a separate wooden bell tower. By the late eighteenth century this building could hold only around 450 people, too few for the growing parish, and a model of it is preserved inside the present church.
Calls to enlarge the old church, first raised by the vicar Anders Swebilius in 1769, went nowhere, and later attempts to put the building work out to tender in 1792 and 1811 attracted no bidders. The parish eventually decided to build afresh rather than repair, and the present stone church was erected in 1829–1830 just east of its predecessor, on the site once occupied by the old bell tower. Designed by Samuel Enander, it was consecrated on 30 September 1832 by Bishop Anders Carlsson af Kullberg.
The church is built in the Empire style, with a rectangular nave, an east-end chancel wall backed by a sacristy, and a west tower with the main entrance, topped by a lantern typical of the period and crowned with a cross. Inside, the hall-church interior is covered by a barrel vault decorated with a painting by Einar Forseth, dated 1929.
The altarpiece, painted in 1874 by Olaus Pettersson, is a copy of Fredric Westin's depiction of the Transfiguration in Stockholm's Sankt Jakob's church, set within an altar arrangement of the same year built to designs drawn up in 1863 by J. F. Hawerman. Gilded columns bearing angel figures support a large sunburst, at the centre of which is a glass painting of Christ as the Good Shepherd, dating from 1903. A triumphal crucifix from the later Middle Ages survives from the older building, its cross-arms carrying symbols of the four evangelists.
Other furnishings include a pulpit designed by Samuel Enander at the time of the church's construction, though moved to its current position only in 1861, and a font dating from 1929. Two funerary hatchments commemorate local nobility, Baron Ludvig Mörner of Råsnäs and Gustaf Ribbing, while a votive ship named Sankta Maria was made by the sea captain August Johansson of Pataholm. The pews date from when the church was built, and the organ loft, though original in structure, was remodelled and decorated by Forseth in the late 1920s. The church has had several organs over the centuries, including an eighteenth-century instrument by Johan Åhrman and a nineteenth-century one by Pehr Zacharias Strand, later rebuilt more than once; a separate small chancel organ was added in 1984.