Medstead is a village in the East Hampshire district of the county, 10 miles S of Basingstoke and 4 miles SW of Alton. The church stands in the village centre, on the N side of the High Street, and is a flint building with ashlar dressings, mortar rendered on the chancel. It consists of a long narrow nave with S porch, a weatherboarded W bell turret, and a N aisle of 2 bays at its E end forming a chapel. W of the arcaded chapel, at the W end of the nave, is a vestry. The chancel is 13thc. (pointed lancets in the lateral walls) with a 14thc E window and a chancel arch of 1833. The church was restored by Ewan Christian in 1859-61. The only Romanesque feature recorded here is the N nave arcade.

There is no separate mention of Medstead in the Domesday Survey, but it was included in a grant of 40 mansae of land (equivalent to hides) by King Ine of Wessex to Winchester Cathedral in 701. (VCH). It was therefore one of the 3 modern parishes included in the Liberty of Alresford in the Domesday Survey. The others are Old Alresford and New Alresford, and the record of 3 churches suggests that each had its own church in 1086. Until recently the church of St Andrew was attached to that of Old Alresford, and the advowson was held by the Bishoph throughout the Middle Ages. Around the turn of the 20th century the two parishes were separated, and on 1 April 2024 Medstead parish was combined with that of Four Marks.

The arcade is of clunch and appears very crisp, although close examination indicates that the capitals are restored rather than replaced. There are also graffiti on the impost of the pier capital, one dated to 1773 in convincing epigraphy. Unusually there is a significant discrepancy between Pevsner (1967) and Bullen (2010); the former dating the arcade to 1200 on the basis of the chamfered arch and quadrant hollow label, and the latter preferring a date c.1160, presumably based on the round arches and relatively plain multi-scallop capitals. VCH also dates it c.1160, as does the List Description.