Middleton on the Hill is a village in the N of the county, 5 miles NE of Leominster and 1½ miles from the Worcestershire border. The village is small and mostly agricultural, with thye church at its centre. St Mary's has a 12thc nave with a S porch rebuilt in 1745, a 12thc chancel, and a 13thc W tower. Romanesque features recorded here are the two nave doorways, the S chancel doorway, the chancel arch, the font and corbels reset as decorative features on the exterior. Above the chancel arch is a plain round headed opening, perhaps into the chancel roof, which is photographed here but not otherwise recorded.

Middleton on the Hill was among the lands belonging to Leominster priory before it was dissolved in the 11thc. By 1066 it was held by Aelfric, and in 1086 it was held by Bernard from Durand the sheriff. Ir was assessed at 1½ hides.

Brooks (2012) notes that the opening above the chancel arch was discovered in 1890, when the roofs were renewed.