The present church occupies a site with notably deep roots in the local landscape. An earlier medieval cross-shaped stone church once stood here, and there has been speculation that a pagan temple may have preceded it, given the presence of a rune stone and graves dated to between roughly 500 and 1000 AD nearby. The churchyard contains gravestones said to be more than five hundred years old, underlining the long continuity of worship and burial on this hillside.
Construction of the current building began in 1836 under master builder Johan Wennberg, to designs by the architect Axel Nyström of the Royal Board of Public Buildings. The first service was held in 1839, though formal consecration did not take place until 1843, led by Bishop Anders Bruhn. The church has seven bays of windows and round-arched portals set slightly back into the wall line, giving the exterior a restrained neoclassical character. Its tower originally carried a lantern, but this was replaced in 1883 by a spire, a change that gives Örby church a distinctive silhouette compared with other neoclassical churches of the period.
The building has been altered and renovated more than once. A sacristy was added along the north wall in 1956–57, and a thorough restoration followed in 1963 to plans by Herman Nordgren, when doors were clad in decorated copper sheeting, limestone floors were laid in the porch and nave, and the pews were replaced, with those beneath the gallery removed entirely.
Among the furnishings, the pulpit and altar rail, with an altarpiece featuring paired columns crowned by a triangular pediment, were made in 1840 by Johannes Andersson of Mjöbäck, who also produced the hymn-number boards. The font dates from 1883, the work of Andréas Olausson. The chancel carpet was woven at Varnhem by Agda Österberg. The church has two organs: a large gallery organ built in 1974 by Hammarbergs Orgelbyggeri of Gothenburg, with mechanical action and a sounding façade, plus a remote division behind the altarpiece, and a smaller chancel organ added in 1993.