A church of this scale is unusual for the Skåne countryside: gothic brick churches of the 15th century were mostly built in towns or as monastery churches, and Fru Alstad is one of only two rural pilgrimage churches in the region to survive from that rebuilding period. The present appearance broadly reflects how the church looked by the late 1700s, though its tower was a later addition. As well as being a place of worship, the church served as a landmark for sailors and, at times, a defensive structure — bullet marks said to survive on the inner south doorway are attributed to the region's turbulent military history.
The church stands beside a spring long associated with pre-Christian offerings, a common pattern where new churches were sited near existing sacred wells to anchor the old beliefs to the new religion. Tradition held that offerings made at Midsummer could cure illness, and pilgrims who had prayed and given a coin would carve their name or mark into the church's pillars, leaving a trace of themselves at the holy site — one such carving on the octagonal central pillar reportedly bears the date 1576. Belief in the well's healing power persisted in folk tradition long after a royal decree of 1665 banned such offerings, apparently continuing into the 19th century.
Among the church's furnishings, the font is the oldest surviving object, carved from Gotland sandstone in the 1100s. A carved oak triumphal crucifix from the mid-15th century is considered a striking example of the direct, earthy style of Skåne folk sculpture. The Baroque pulpit dates from the 1730s, and the altarpiece, carved and painted oak from 1689, includes a Last Supper scene in which one disciple is said to be a portrait of the parish's then vicar. Fragmentary lime-wash paintings on the nave walls and vaults, dated to the 1400s and 1500s, depict biblical scenes and saints and are linked stylistically to similar work in Skanör.
Several more curious details reward a closer look: two wooden figures on the chancel's south wall, probably from the 1600s, are usually identified as Peter and Paul, though a local legend claims they originally depicted Joseph and the Virgin Mary holding the infant Christ — reportedly altered after the Reformation when veneration of saints was banned. On the organ loft, a set of painted scenes from the Passion, dated 1742, contains a couple of oddities noticed by visitors, including a figure of Christ apparently given two right feet. A royal cipher of Karl XI, once prominently displayed over the altar as a symbol of Skåne's incorporation into Sweden after 1658, now hangs in a less conspicuous spot near the gallery.
In the churchyard, an unusual grave shaped like a prehistoric stone cist marks the burial of a local farmer and antiquarian who spent his life collecting artefacts and unusual plants and writing about the local district; his collection is now held in a nearby museum.