Middleton has, after the collegiate church in Manchester which later became the cathedral, the most significant survival of a medieval church in Greater Manchester. It consists of a pair of through arcades with clerestory, and a W tower heightened by a curious wooden bellcote probably around 1667, when new bells are recorded as being hung. The church's main interest is its heraldic rood screen, and stained glass commemorating archers of the Battle of Flodden Field, but also contains significant Romanesque fragments built into the late medieval structure.

Lancashire is poorly recorded in the Domesday Book and Middleton does not recieve a mention (the closest settlement to do so is Salford). In the 1291 Taxatio, the benefice of Middleton was assessed at £13, 6s, 8d. The church's fabric has two major documented phases. The exterior walls, tower, and arcades were constructed by prolific prelate and statesman Thomas Langley in 1412, as part of the medieval trend of endowing churches in the village of one's birth. This is probably when the Romanesque church was taken down and its carved fragments reused. In 1524, the church recieved its clerestory and elaborate parapet-work on the S face due to Richard Assheton, brother of parish priest Edmund Assheton.

The billet work is obviously not in-situ, but the tower arch also clearly has been cobbled together, with voussoirs recut in order to make a new pointed arch. Whether it was originally for a tower or was a chancel arch is essentially unverifiable. The nook shaft fragment in the N aisle is not mentioned in the Buildings of England.

Cardinal Langley's retention of the Romanesque ornament is interesting in itself. A building break to the E of the billeted arch suggests the arcade was extended by one bay in 1524. Therefore it would have been the original end of the aisle and presumably would have contained an altar, and the ornament would have signified this, perhaps marking the site of a chantry for Langley. Langley was buried against the former W door of the Galilee Chapel in Durham Cathedral, a 12thc structure that significant consolidation of which was undertaken during Langley's time as Bishop of Durham, showing a similar reverence (but far from authentic conservation in the modern sense) of Romesque fabric.