The core of the present building incorporates parts of a small, tower-less church from the early twelfth century, similar in type to the original church in the neighbouring parish of Almby. In the early 1200s a tall, narrow tower of the so-called Närke type was added, featuring round-arched sound openings in the bell storey. This tower received a tall, pointed spire in 1697, though rot damage to the internal timber frame led to the spire being significantly shortened during repairs in 1903.
In 1760 the church was enlarged with a north transept. At the same time the medieval vaults were demolished and replaced with plastered wooden barrel vaults, and the windows were widened to their present size. Further substantial renovations followed in 1891 (new pews), 1959 (under architect Martin Westerberg, when the organ was relocated to the south gallery), and 1987–88, when the interior fittings were repainted and new lighting installed.
Among the church's furnishings is a large altarpiece depicting the Descent from the Cross, attributed to the court painter David Klöcker Ehrenstrahl or one of his pupils. It originally belonged to the chapel at the Dylta sulphur works in Axberg parish; it was purchased at auction in 1820 and subsequently donated to Gällersta kyrka.
The pulpit is counted among the oldest in the Diocese of Strängnäs. It was donated in 1593 by the vicar Andreas Birgeri and made by the master carpenter Hans Kanternitz of Örebro, with its canopy likely added around the mid-1600s. The octagonal font, carved from sandstone, also dates from the mid-seventeenth century.
The church organ has its own layered history: an instrument built in 1879 by E. A. Setterquist & Son of Örebro was later replaced by the present pneumatic organ, built in 1940 by the same firm's successor and retaining the 1879 façade. It was renovated and its stops reorganised in 1972.