The very first church associated with Sandhem is said to have stood a few hundred metres to the south-east, close to the ancient Eriksgata route, though little more is recorded of that early building. The present structure was built between 1838 and 1841 to designs by the architect Carl Stål, and walls from earlier churches on the site are said to be incorporated into the current fabric. The building consists of a nave with a west tower and a straight-ended chancel of the same width as the nave, with a sacristy added to the north side and a porch added to the south in 1913.
Among the church's furnishings, the font in the chancel dates from the twelfth century and is attributed to the so-called Bolum school of stonecarving; a second, later font from 1913 stands in the south porch. A striking survival is a gilded copper and enamel processional cross from Limoges in France, dated to around 1200, giving the church a continental medieval object of some rarity for a rural Swedish parish. A triumphal crucifix is dated to the fifteenth century, and the altarpiece, painted in 1866 by A. G. Ljungström of Axtorp, depicts the Transfiguration of Christ.
The church has had a succession of organs, beginning with an instrument by Jonas Wistenius in 1746, followed by later rebuilds in the nineteenth and twentieth centuries; the case front from the eighteenth-century organ survives on the west gallery, a reminder of the building's long musical history even though the mechanism itself has been replaced more than once.
Several funerary hatchments (heraldic memorial shields) are also preserved within the church, a common feature of Swedish parish churches associated with local landed families.