The foundation stone was laid on 6 May 1844[1] and the completed church was opened on 15 September 1846 by the Bishop of Lichfield.

Derby painter Joseph Wright was re-buried in St Alkmund's churchyard upon completion of the building in 1846.

Other buildings of interest included The Lamb Inn, opened in 1835, which featured its own brewery; a gabled sweet shop dating from the 17th century sited on the corner of the square and Bridgegate; and several shops dating to medieval times, located at the Queen Street entrance to the yard.

[8] This organ was found to be inadequate, and in July 1888 it was replaced by a new instrument costing £1,200 (equivalent to £168,800 in 2023)[3] constructed by Thomas Chambers Lewis.

Part of this scheme was to build a road that would carve through the site of the church and the churchyard, which met with strong criticism from many Derbeians.

During the works, the site of the original church was uncovered, along with a stone sarcophagus believed to be St Alkmund's and several other artefacts.

[5] These are now on display in Derby Museum and Art Gallery, together with remnants of a 4-metre (13 ft) tall stone cross carved on four sides with birds and animals, which was removed from the churchyard during the 19th century.