Gothenburg was founded as a city in 1621, and German and Dutch residents, alongside Swedish inhabitants, soon began building a church on the site of the present cathedral. It took its name from Gustav II Adolf, the city's founder, and the first permanent church was inaugurated in the early 1630s, though accounts of the exact date vary. The Diocese of Gothenburg was established some decades later, in 1665, when the church formally gained cathedral status.
Fire has shaped the cathedral's history more than once. The building was destroyed in blazes in 1721 and again in 1802, each time requiring substantial rebuilding. After the second fire, the elderly architect Carl Wilhelm Carlberg, already responsible for several notable Gothenburg buildings, was commissioned to design the current church. It was inaugurated in 1815, though the tower was not finished until the 1820s, and further work continued into the 1830s.
The surrounding square was the parish churchyard for roughly two centuries, until burials moved to Stampen's new cemetery after the 1802 fire. Estimates suggest that as many as 20,000 people may have been buried in the area around the cathedral over the centuries, a fact commemorated by a plaque on the building's east side.
The cathedral's architecture is classicist, with a west portal supported by Doric columns cut from Scottish sandstone, and pilasters and decorative friezes in a similar style around the exterior. Inside, the mood is light, created by white paintwork and gilding rather than the coats of arms typically found in older Swedish churches, a feature attributed to the losses suffered in the 1802 fire. Ionic half-columns in the chancel, made of wood but marbled to resemble stone, reflect the same classical taste, while the pulpit and other fittings show the influence of the Empire style.
Among the furnishings, the altar sculpture depicting Christ's cross flanked by two angels dates from the mid-1700s and survived the 1802 fire; it is attributed to the sculptor Jacques Adrien Masreliez, working under the architect Carl Hårleman. The building has been renovated repeatedly since, including major structural work in the mid-1950s to stabilise the foundations, and further renovations in the 1980s and again between 2013 and 2015, the latter intended to improve accessibility and refresh interior surfaces, including new spaces for prayer and a chapel dedicated to Mary Magdalene.