The church's story is closely tied to that of Öregrund itself. The town received its charter in 1491, which came with an obligation to build a church, and construction is understood to have begun that year, though the completion date is uncertain. The building is a simple rectangular hall church with a straight-ended chancel, a sacristy to the north and a porch to the south, built of rendered natural stone with some brick, and covered internally by a flat timber ceiling; no early wall paintings survive.
Fire has shaped the building more than once. The church burned in the town fires of 1652 and 1719, the latter during the Russian raids on the Swedish coast, which left it without a roof, sacristy or porch and destroyed much of the furnishings. Rebuilding continued for decades afterwards: the present sacristy dates from 1734–1737, and in 1763–64 much of the interior was renewed, including a new altarpiece and gallery. Later restoration, notably one led by architect Anders Roland in 1914, altered details such as the gallery height and wall finishes but did not significantly change the church's overall architecture.
In the late 17th century the porch was extended westward to house a burial chapel for the Brask family, completed in 1691; it was cleared in 1820 and is now used for storage. A detached, shingle-clad bell tower stands on a hill south of the church, its weathervane bearing the date 1736, likely marking repairs to an earlier tower of 1690 that burned in 1719; the smaller bell was cast in 1650 and the larger in 1752.
Among the church's furnishings, the medieval altar cabinet from around the mid-1400s, given to the church in 1664 from Klara kyrka in Stockholm, stands against the south wall of the nave. Two 18th-century votive ships hang in the western part of the church, evoking the town's seafaring and fishing families. The pulpit, carved and painted with gilded ornament, was made in 1729 by the sculptor Johan Pouset, while the current altarpiece dates from 1763. The church's pipe organ was rebuilt in 1996, replacing earlier instruments from 1914 and originally 1836.