The church's tower and the south-western part of the nave date back to the twelfth century, though later rebuilding altered its appearance considerably. By the 1730s the congregation had outgrown the building, and a provisional enlargement followed; in 1756 the north wall and east gable were moved outward, leaving the tower in its present asymmetrical position. A sacristy was added in the 1770s, and a major 1949 restoration brought lighter interior colours and electric lighting.
On 29 March 2007 a fire that began in a workshop across the road spread to the church and destroyed it almost entirely. One person was seriously injured in the original blaze, and a firefighter was slightly hurt while tackling the flames at the church, reportedly turning his hose on himself for protection. Remarkably, several loose furnishings were rescued, including the altarpiece, the font and a medieval altar cabinet.
Rebuilding took place between 2009 and 2011, following designs by the architect Per Rydberg, and the church was reconsecrated in May 2011. The result gives Älvestad kyrka a somewhat unusual character: a building with genuinely medieval roots but largely new fabric, fittings and even bells, cast in 2011 by the Bergholtz foundry in Sigtuna.
Among the surviving treasures is an oak altar cabinet made in an Östergötland workshop in the second half of the 1400s, restored in 1923 after being found in poor condition. The altarpiece itself, depicting the Annunciation, the Last Supper and the Passion, was donated in 1799 by Lieutenant General Carl Gustaf von Roxendorff of Carlshof. The pulpit is in Caroline baroque style, and the brass font, with its richly ornamented bowl and lid, was given by Claes Niethoff of Borringe in 1661.
A curiosity among the church's older possessions is the so-called Ringkavlebudkaveln, a message-stick recording which farms in the parish were obliged to ring the church bells — an unusual survival of parish administrative custom.