When Baltimore Town was founded in its present location in 1729/1730, the parish moved to "Lot 19," in the Original Survey" of 1730 at the highest point just inside the original town boundaries on the north end which were purchased from Charles Carroll of Annapolis, (1702-1782), (father of nationally famous Charles Carroll of Carrollton, (1732-1832), later longest living signer of the Declaration of Independence, only Roman Catholic to do so, and wealthiest man in America).

Here a small brick church, (facing south towards the harbor), a rectory and some cemetery plots were placed in 1739 on a cliff overlooking the Jones Falls stream (which divided the town from adjacent Jonestown to the east and Fells Point to the southeast waterfront) and northwest of the original Courthouse Square (later became Battle Monument Square after its construction, 1815-1822) at North Calvert between East Lexington and Fayette Streets.

The present "Old Saint Paul's Church (as it is generally known throughout the state) is located now on a portion of that property, in the northwest corner of the original platted lot of 1730.

Construction of King Boulevard in the late 1970s required that a portion of the historic cemetery on its western side was taken for road and sidewalk use and the ancient plots and stone wall were moved slightly eastward and reconstructed.

The first "daughter" congregation, Christ Church (closed 1986), was created in 1796 near the present day War Memorial/City Hall Plaza at the southwest corner of South Gay and East Fayette Streets.

This neo-classical structure faced towards the west on Charles Street, seated 1,600 people in the main level and galleries and was graced with a 126 foot high spire.

John Sebastian Bach Hodges replaced the church's paid quartet with a professional Choir of Men and Boys, which sang continuously for 141 years.

Noted former Organist/Choirmasters of Old St. Paul's include Rodney Hansen, Daniel Fortune, Jeremy Filsell, Diane Meredith Belcher, and Douglas Buchanan.

The exterior facade features two bas-reliefs of Christ and Moses, executed by the Italian sculptor Antonio Capellano (who also sculpted the statue on the top of the Battle Monument) that were originally part of the façade of the previous Robert Cary Long church.

The Greek columns were painted a sandstone orange, with an elaborate color scheme of brown, red, and yellow ochres dominating the rest of the nave.

In the summer of 2013, the interior of the church underwent a historic restoration that included painting the nave and adding a blue field with gold stars to the ceiling.

Prominent members of the parish include Samuel Chase, John Eager Howard, Thomas Johnson, and William Donald Schaefer (mayor of Baltimore and governor, comptroller of Maryland).