The church's oldest timbers have been dated by tree-ring analysis to around 1077–78 for the chancel, with the nave possibly built a little later, making it one of the oldest churches in the province. It began as a Romanesque church with an apse, and was extended westward at the end of the 1300s; the corner of the original west wall survives as an arch inside. During the Middle Ages a chapel and sacristy were added on the north side of the chancel, and the vaults seen today were built around 1485, when larger windows replaced the original small Romanesque openings.
Local tradition holds that two churches once stood close together at Gökhem for several centuries – the present building and the now-ruined Överkyrke – and one story suggests German and English monks each built their own church nearby, an idea supported by the differing chancel shapes (a straight end at Överkyrke, an apse here). It is an engaging tale, though it should be treated as tradition rather than established fact.
The entrance porch was originally a medieval confessional chapel. After the women's offering altar was removed and a Madonna image placed there in the 1700s, it became known as the Virgin Mary's Choir. The Madonna was moved several times during later renovations and is thought to have been destroyed, along with other medieval furnishings, during a thorough restoration in 1913 led by Gustaf Lindgren, when the floor was relaid in limestone and old grave slabs removed.
The same 1913 restoration nearly saw the interior walls replastered, which would have destroyed the medieval paintings beneath centuries of limewash and soot. Lindgren regarded this as tantamount to vandalism and halted the work, allowing the paintings – attributed on stylistic grounds to the medieval painter known as Mäster Amund – to be uncovered and conserved, both in the nave and chancel. Some retouching during conservation is thought to have altered parts of the original work.
The result is an interior densely covered in paintings in muted browns, greens, yellows and blue-greys, depicting biblical scenes, prophets, the Creation, and the legend of St Catherine of Alexandria in the porch, among other subjects. Much is damaged, particularly on the south wall, but enough survives to reward unhurried, attentive viewing. The church also holds two twelfth-century font basins, one of which is believed to have come from the vanished Överkyrke church, and a bell-tower said by tradition to have been built by Russian prisoners of war in 1720.