The church's origins reach back to the 1100s, when a Romanesque building with a narrower chancel stood on the site. Its west end still incorporates medieval masonry, though the original chancel was demolished in the 1300s when the building was extended into a hall church. From that early period only the font, carved from Gotland limestone, survives.
Hörningsholm, first recorded in the 1300s, held the right of patronage over the church and its clergy for centuries, an arrangement not formally abolished until 1921. When Ebba Grip inherited the estate in 1660 she funded significant rebuilding, including strengthening of a failing wall and the addition of a south transept. A further, more drastic transformation followed in 1787–1789 under Count Nils Bonde and his wife Anna Christina Fleming, who had the church reshaped in neoclassical style, with old brick vaults replaced by plastered wooden barrel vaults and the entrance moved to the west gable. A burial vault for the Bonde family was built beneath the floor, and in 1841 a further, cylindrical Bonde burial chamber was added beside the south transept.
The altarpiece, painted in 1790 by Johan Ahlberg, depicts Christ in Gethsemane and is flanked by figures representing Faith and Hope; sources differ on whether these are painted trompe l'oeil panels or marble statues. It was given, along with related furnishings, by Nils Bonde and Anna Christina Fleming at the time of the restoration. The pulpit is usually dated to the 1660s, though it was later moved from its original position, and its painted decoration was uncovered from beneath later overpainting during a 1933 restoration.
The church's first organ, built in 1789–90 by Jonas Ekengren of Stockholm, has long since been replaced internally, but its elegant neoclassical case survives; the present mechanical organ dates from 1974. Among the furnishings are older textiles, including a mid-18th-century vestment and altar cloth of French silk brocade, gifts from members of the Bonde family, along with fine silverware acquired or donated over the eighteenth and nineteenth centuries.
The most striking monument is a large, richly decorated limestone tomb chest commemorating Mauritz Sture, a councillor of the realm who died in 1592, and his wife Anna Horn af Åminne. Despite its grand form, the couple were not actually buried within it but in the Banér family vault beneath the south transept; a space left for the wife's date of death was never filled in, although she died in 1617. Elsewhere in the church, carved and painted funeral hatchments commemorate later owners of Hörningsholm, including one raised for an infant son who died at not much more than two months old.
On the hill west of the church stands a detached wooden bell tower, unusual for never having been clad in boarding, leaving its two bells fully visible. The larger bell probably dates from the early 1500s and bears apostle figures and the seal of Stockholm's Guild of St George, for reasons that remain unexplained; the smaller bell was cast in 1742 at the expense of Elsa Elisabet Banér of Hörningsholm.