The church occupies the highest point in Malmö, around 37 metres above sea level, in the city's south-eastern reaches. Fosie by (village) was first recorded in 1299 in a papal letter, where it appears as Fusehöö, a name thought to mean 'high marshland'. Little is known for certain about the earliest church here, believed to have been a stone building with a nave, two vaults and an apse, probably dating from the latter part of the 1100s.
Much of that medieval structure has since disappeared, but around half of the original nave survives, along with parts of the tower, whose exact age remains uncertain—some elements are thought to date from the late medieval period. A memorial stone from 1615, bearing a Latin inscription, records that the church gained a chancel at that time. The building took on its present appearance following a major rebuilding in 1896 to designs by the Malmö architect August Lindvall, working in a neo-Gothic style; this work added the transepts and replaced the tower's stepped gables with a spire, though it also meant the loss of much of the church's medieval character. A further restoration in 1971 gave the interior its current pale green colour scheme and more comfortable pews.
Among the notable furnishings is a sandstone font dating from the 1100s, attributed to the so-called Oxie Master, Mårten Stenmästare, or one of their pupils. Above it hangs a large brass dish made in Nuremberg in the 1500s, decorated at its centre with a depiction of the Annunciation. The church also holds Malmö's only known rune stone, the Fosiesten.
In the chancel, look out for a stained-glass window of a blessing Christ, created in 1896 by the artist Anders Nilsson of Lund.
The church has had several organs over the centuries. An instrument installed around 1839–40 was followed by a 14-stop organ built in 1900 by Salomon Molander & Co of Gothenburg, later enlarged in 1937. The current organ, built in 1974 by Anders Persson Orgelbyggeri of Viken, retains the façade from the 1900 instrument.
Adjoining the parish hall stands S:t Thomas kapell, added in 1969, with an almost square worship space, an angled roof and exposed red structural elements.