St Paul's was designed by Thomas Brine and consecrated in 1822, built to serve Ramsey's rapidly growing population after the town's earlier chapel of ease at Ballure became too small. A west gallery for musicians (clarinet, fiddle and serpent) was added in 1830, ahead of the church's first organ in 1852, and two side wings followed in 1844; a new vestry was built in 1874 and a porch added in 1938. Standing on the south side of Market Place, it is one of the few surviving buildings of Old Ramsey after the town's centre shifted south during redevelopment in the 1960s, and it was registered as one of the Isle of Man's Registered Buildings in 1985.