Presteigne's Welsh name Llanandras, means the holy place of St. Andrew and there has been a place of Christian worship on the site since before the Norman Conquest. The present building is an outstanding medieval church with some remnants of the old Saxon and Norman structures remaining, and considered the finest in Radnorshire. Among the many treasures at St Andrew's is the beautiful Flemish Tapestry depicting the entry of Christ into Jerusalem, which celebrated the 500th anniversary of its creation in 2010. The Victorian East Window is a particularly fine example of its type and there is a working carillon in the tower. Rising and curfew bells ring out from the tower every morning and evening - a tradition only rarely kept today. A comprehensive guide book is available.
The church is the main venue for concerts in the Presteigne Festival of Music and the Arts held over every August Bank Holiday. The festival consists largely of music written by living classical composers.
There are, however, many other music and arts events held at the church every year, making the most of the building's remarkable space and superb acoustic.