The church has a W tower (rebuilt 1663), an Anglo-Saxon nave with 13thc. N and S aisles (clerestorey over N arcade only), and a square-ended chancel with a 12thc. chancel arch. There is a vestry at the E end of the N aisle. A plain 12thc. doorway in the N aisle must be reset.
There was certainly a Church of Pattishall in 1086, since it is named as the owner of land in Cold Higham held by Godwine of Walter the Fleming. This holding includes a priest, but curiously Pattishall itself is not recorded as a unit of assessment. By c.1200 there were two vicars who shared the dues of the church in a ruling of a case of that date, heard before the abbess of Godstow and the prior of Dunstable. There is no doubt, therefore, that Pattishall was anciently an important church, and Franklin has argued that it was previously a minster. In the 1130s Simon de Wahull gave half of the church to the nuns of Godstow. His son Walter gave the other half to the priory of Dunstable before 1176. Two vicars served concurrently until the Dissolution.
Benefice of Pattishall with Cold Higham and Gayton with Tiffield.
The limestone chancel arch is deep with a slightly depressed round-headed arch. The W face comprises two rows of plain voussoirs, the outer slightly proud of the inner, and a label. The impost blocks, which lie flush with the wall on the E face, are carved with incised decoration on their W faces, and on the embrasures of the arch. That on the S side has pointed cusped ornament on the face, and zigzag on the chamfer. The N impost block has a plain moulding on the upright, and again zigzag on the chamfer. The SW corner of the N impost has been mended with a modern insert.