The church is one of three in Cornwall dedicated to St. Piran. Piran, reputedly a son of Ireland, may actually have come from Perranzabuloe in Cornwall, the main cult centre with another ‘Piran’ church being established at Perranarworthal. Perranuthnoe church is first mentioned in 1348, though its first rector is named in 1277.
The church acquired an additional patron saint – St Nicholas – in 1856, today replaced by St. Michael. A 1980 painting of the legends of St Piran by local artist Rosemary Ziar and modern sculpture of St Piran created by Annie HenryHolland and dedicated by Bishop Bill Ind in 2008 can be found in St Nicholas chapel in the south transept.
The Whalesborough family and their successors, the Trevelyans of Marhamchurch were patrons of the living until very recently. They were also generous benefactors to the church, for example Sir John Trevelyan gave a St George banner in 1519. Today the Dean and Chapter of Truro Cathedral present the rector.
Perran's most distinguished Rector was Sir Michael Tregorra, who was instituted on September 21st, 1427, and resigned in 1433. Born at Tregurra, in St. Wenn, Tregurra was a career clergyman and Oxford-educated. After leaving Perranuthnoe he became Henry VI’s chaplain and in 1440 first Rector of the University of Caen, in Normandy. From 1449 until his death in 1471 he was archbishop of Dublin and his effigy, still to be seen in St. Patrick's Cathedral, was restored by Dean Swift.
Perranuthnoe church probably started as a two cell building with just a chancel and nave like most Cornish churches. Of this church a Norman font, possible corbel heads, now associated with the south door, and some walling survives. Transepts with pointed arches were added before 1348 when the church is mentioned for the first time.
An aisle, suitable for parish processions was added on the north side, and a three-stage unbuttressed tower c.1500. A second south aisle was clearly being planned at the time of the Reformation in the 1540s, but, as at Cury, was never built. Had it been built; the redundant rood stair in the south transept would have been swept away. This, like its northern counterpart, once gave access to a service loft on top of the original screen where a crucifix or rood, and an organ may once have stood. Good post-Reformation features include the oak pulpit placed in the church in 1740 and the royal coat of arms of 1814. Three bells in the belfry are dated 1636, 1688 and 1832.
In recent years much has been done to restore the church to its former beauty. In 1926 the chancel screen, choir stalls and reredos were added in memory of a former general manager of the Great Western Railway, while the altar and communion rails commemorate the longest serving incumbent, Rev. Richard Astley (1850-1902), and his wife. Reredos figures included St Piran and his millstone. In 1937 the Chapel of St. Nicholas, in the south transept, was restored to use in memory of Canon Purves, and in 1952 Miss C.C. Astley presented a new font cover to the church.
On the east wall of the tower there is a chiming clock given in memory of Eliza Trevelyan in 1913, which was restored by public subscription in 1984 and its face repainted and gilded in 1999. In 2009/10 it was necessary to replace the rusted support beams. Funding was achieved from local events and a generous grant from Cornwall Historic Churches Trust. Baptisms and burial registers date from 1562; the marriage registers from 1589 and are now kept in the Cornwall Record Office in Truro.
One of the most curious features in the church today is the little granite figure of St James the Great set in the south wall above the entrance. This came from a former chapel founded at Goldsithney in September 1400 by John Andrew. This chapel fell into ruins in the 18th century, and has now disappeared, but memories of Goldsithney’s famous fair still linger.