The nave of the church has four-bay, pointed arcades of the end of the 12th or early 13thc. In the late 13th or early 14thc. the chancel was rebuilt and a south chapel was added to it in 1861 by G.E. Street. The tower is Perpendicular in style. The church was restored in 1889-90 by C.E. Ponting.

Pewsey church was standing in 1086, when it was held by Rainbold the priest: that it was then referred to as standing on the king's estate may suggest that it was built before 940. In the 13thc and until the earlier 15thc the church was served by both a rector and a vicar.

Pevsner says that the arcades are formed by being cut out of earlier lateral walls.