The church's western section is thought to date from the medieval period, while its eastern part, including the chancel, was added in 1741, when a timber porch was also built. The sheltered, water-bound location is said to have made the site a refuge during unsettled times in the Middle Ages, and the same setting later helped make Fivlereds kyrka a popular choice for weddings.
Most of the interior fittings date from the 19th century. During restoration work in 1954, the interior was repainted and electric lighting installed. Older wall paintings were uncovered at that time, but they were too damaged to be restored and remain only as traces on the walls today.
On the old stone altar stands a Baroque-style altarpiece depicting Christ on the cross flanked by two female figures, the work of Jöns Lindberg of Sandhem parish. It was donated by lagman Johan Timell in 1792 and remains one of the church's most notable furnishings.
A font of sandstone, carved in two parts around 1200, is one of the oldest surviving objects in the church, plain in decoration but with a distinctive rounded, ridged foot. The church's number board, in Gustavian style with a hand-shaped holder pointing upward, is also worth a second look, as is the timber bell tower, dating from the 1700s, which houses a medieval bell with rough incised crosses and faint, seemingly meaningless rune-like marks, alongside a smaller bell cast in 1699.