Traces of an earlier wooden church, with a brick sacristy, are said to have stood nearby; a 17th-century antiquarian recorded remains of this predecessor in his travel notes. The present brick church, raised on a granite base, originally consisted only of a nave and chancel. The sacristy and porch are thought to date from around 1468, when decorative murals attributed to the so-called Tierp school of painters were added. These paintings survive today only in the porch and sacristy, since later work in the chancel and repeated whitewashing removed other schemes.
The church's stepped gables and larger windows date from renovations around the turn of the eighteenth century. Its history took a violent turn on 25 July 1719, when Russian forces raiding the Uppland coast burned the church, bell tower and rectory, badly damaging walls and vaulting and destroying the interior fittings. The building stood derelict for several years until the De Geer family funded its rebuilding, and the church was reconsecrated in 1726. In gratitude, the parish granted the De Geer family patronage rights over Österlövsta.
A notable addition is the Baroque burial chapel built onto the church's east gable for Charles de Geer, who died in 1730. Work continued for several years, and his marble sarcophagus was not completed until 1733; the identity of the architect is unknown, though the mason, sculptor and coppersmith involved are recorded. The interior is considered a fine example of Swedish Baroque work, though not everything was finished — several intended wall sculptures were never carved, leaving only their bases in place.
Inside, the altarpiece, pulpit and font all date from the rebuilding after the fire and display the De Geer coat of arms and monogram alongside their religious imagery; the altarpiece depicts the baptism of Christ, flanked by figures representing faith and hope, and its original colours were uncovered during a 1956 restoration. The pulpit carries relief carvings of the four evangelists and Christ as ruler of the world. The organ's history is layered: an instrument built in 1725 by Johan Niclas Cahman was largely replaced in the 1880s, though its facade and one original stop were later reinstated during a 20th-century rebuild.
Outside, the churchyard is enclosed by a medieval wall, with two gated entrances dating from the 17th century, and the freestanding bell tower, probably built around 1723, houses three bells — two are said to be 1722 gifts from Charles de Geer, while the largest was cast in Stockholm in 1813. The church reopened in 2017 after renovation work addressing heating, drainage and roofing.