The oldest parts of the church, built of worked flint and Helsingborg sandstone, date to the 1100s, when it was constructed in Romanesque style. Sources differ slightly on the sequence of later additions: one account describes a tower added around 1300 with further rebuilding and extensions through the 1400s and 1500s, including a north transept and an enlarged chancel; another account focuses on major changes in the late 1700s, when a new aisle was built, the tower rebuilt, and the Hamilton family chapel and sacristy added, while an earlier south porch was demolished.
Above the main entrance, wrought-iron anchors on the tower's west facade form the date 1772 and the initials of Gustaf David Hamilton, then owner of Barsebäck estate. Between 1649 and 1922 the estate's owners held patronage rights over the church, and the Hamilton family grave lies in the south-eastern corner of the churchyard.
The interior retains wall paintings from several centuries, the earliest dated to the 1100s and 1200s, with further additions in the 1400s, including a devil figure on the nave's west wall, and more work carried out in the 1600s and 1700s. A carved Romanesque door with decorative ironwork also survives from the earliest building; specialists have proposed varying dates for its ironwork and timber, ranging from around 1150 to the late 1100s.
The sandstone font, thought to be the work of the medieval master mason Mårten Stenmästare, dates from the 1100s and is decorated with carved palmette and interlace friezes; its brass basin is a Nuremberg piece from around 1550. The oak pulpit is dated 1637, though later altered, and its carved panels depict biblical scenes including the Nativity and Crucifixion. The altarpiece, from the 1760s, carries carved Hamilton and Hildebrand family crests and a painting of Christ in Gethsemane by court painter Carl Gustaf Pilo. A large oak triumphal crucifix, of Danish or Scanian workmanship from around 1500–1520, is possibly linked to the workshop of Claus Berg in Odense.
The chancel window's stained glass, showing Christ in the landscape around Barsebäck, was created in 1951 by the Helsingborg artist Hugo Gehlin. The church bells include a small one dated to the mid-1200s, among the oldest in the region, alongside a larger bell recorded as either from 1759 or associated with later works depending on the source. The current pipe organ was built in 1942 by A. Mårtensson's organ workshop in Lund, replacing an earlier harmonium.