The church began as a Romanesque apse church built of split fieldstone at the end of the 1100s, and the nave and part of the chancel survive from this earliest phase. Over the following three centuries it was substantially enlarged: transepts were added in the 1200s using brick surrounds around the openings, and during the 1300s the whole building was given Gothic vaulting, with the chancel extended and squared off, and a sacristy added. The imposing west tower, with corner buttresses and blind niches, was built in brick towards the end of the 1400s and houses three bells cast between the 16th and 17th centuries, two of which have since been recast.
The building suffered badly during the Nordic Seven Years' War, and tradition holds that marks on the great oak door date from the Ronneby massacre of September 1564. The church stands in Bergslagen, Ronneby's oldest surviving district, which was spared when a major fire swept through the town in 1864.
Inside, seven of the eight vaults are cross-vaulted, while the north transept uniquely has star vaulting. Most of the surviving wall paintings date from the late 1500s and early 1600s, though a few earlier fragments remain, most notably a large late-15th-century depiction of St Peter enthroned as pope, holding a book and an oversized key, along with a fragmentary image of St George and the dragon and some consecration crosses.
The furnishings are unusually rich for a parish church of this size. A bronze font was made in Germany in 1604, and a triumphal crucifix with evangelist symbols dates from the 1500s. The elaborate Renaissance altarpiece of 1652, a gift from Ronneby's burghers, depicts the Last Supper, the Crucifixion and the risen Christ in three tiers, while the pulpit of 1640, thought to be of Scanian or German workmanship, is carved with figures of the four evangelists and St Paul. The church also contains numerous 17th- and 18th-century gravestones and painted epitaphs commemorating local burgomasters, merchants and their families, some with lengthy Latin or Danish-Swedish inscriptions.
The chancel's colourful stained-glass windows were added in 1955 by artist Erik Olsson of the Halmstad Group, taking their theme from Psalm 84 in reference to the Ronneby-born archbishop and hymn writer Haqvin Spegel. The church's organ has a long history: an instrument is recorded from 1636, replaced in the 19th century and enlarged several times since, most recently in the mid-20th century and again in 2010.