The church is dedicated to Saint Margaret, patron saint of farmers and of nursing and expectant mothers. It was originally built with a chancel, apse and nave, with a square west tower added later. During the 1400s vaults were added to the building, and in 1836 extensions were built onto the north and south sides of the nave.
A thorough restoration at the end of the nineteenth century uncovered wall paintings from the 1400s that had been covered over with limewash, offering a glimpse of the church's medieval decorative scheme.
Like many Swedish churches, Östraby was reshaped by the Reformation in the 1500s, a change felt in both the conduct of services and the appearance of the interior. Infant baptism no longer involved full immersion, so a shallow dish was fitted over the font's basin, and side altars dedicated to saints were removed.
Among the older furnishings still in the church are a font from the Romanesque period and a crucifix from the late 1400s. There is also an altar cabinet from the second half of the 1400s, which includes a depiction of Saint Anne with the Virgin and Christ child, a popular devotional subject in the late medieval period.
The present organ was built in 1953 by Wilhelm Hemmersam of Copenhagen, replacing earlier instruments installed in 1867 and 1902; its case dates from the same period as the organ itself.
The nineteenth-century clergyman Peter Wieselgren served as vicar in Östraby during his career, a notable figure associated with the parish's history.