St. Andrew's Church was founded in 1889 as a mission of Christ Church with services in the railroad depot on Charlotte Pike until a church was built at the corner of 47th and Georgia Avenues in 1892. That building was demolished by a tornado and its replacement by lightning. A new church was consecrated in 1902 on the corner of 49th and Michigan Avenues.

In 1908, the Rev'd J.F. McCloud became the first full-time Vicar and served until 1918, to be succeeded by various clergy from Christ Church until he was called back in 1924. In 1927, he moved the congregation to the southeast corner of 46th and Park Avenues, with the chapel itself transported on rollers. In 1933 a new church of stone was begun, the old church becoming the parish house. When Fr. McCloud died in 1946; Christ Church presented the mission a new pipe organ a year later in his memory. The Rev'd Frank E. Walker, who became Vicar of St. Andrew's in 1949, was responsible for converting the old frame church annex into a modern parish house.

In 1956 Bishop John van der Horst ordained as deacon the Rev.'d Donald E. Mowery and assigned him immediately to be in charge of St. Andrew's. After his ordination to the priesthood on January 18, 1957 (the first ordination to occur within the mission), Fr. Mowery began the celebration of Masses daily in St. Andrew's; and Bp. van der Horst's wish that the church become Anglo-Catholic in orientation was realized. Under Fr. Mowery's leadership, parish status was granted in January 1960.

On the feast of the Ascension in 1963, the Rev'd Edwin L. Conly of Dallas celebrated his first Mass as Rector. Under his leadership, the Parish decided in 1964 to leave its West Nashville home of seventy-five years and move to the former Robert Cheek mansion at 3700 Woodmont Boulevard in Green Hills. On August 27, 1965, with the Litany of Saints sung in procession, the Parish came on to the Woodmont property for the first Mass in the new location.

When the Cheek house proved too small for all congregational purposes, ground was broken in 1968 for what was to be a temporary chapel to serve until a larger church could be built. On the 16th Sunday after Trinity, September 21, 1969, the new building became the location for daily offices and Masses, while the Cheek house continued to serve for hospitality, offices, and classrooms.

On the last day of October in 1985, Fr. Conly retired after twenty-two years as Rector of St. Andrew's, and the Rev'd George C. Stacey from the Diocese of Milwaukee became the third Rector of the Parish with the celebration of Mass on All Saints' Day. On the feast of St. Andrew in 1989, the Parish celebrated the Centennial of its founding with a High Mass at which Fr. Mowery was celebrant on his first return to St. Andrew’s since leaving for Memphis.

Fr. Stacey realized that the Parish had no long-term planning. After deliberation, plans were begun to replace the Cheek mansion and construct a new church building, with the 1969 building to become the parish hall as originally intended. The Vestry realized that such a plan would have left the Parish without classrooms and offices while replacing a building that had served very well as the Parish's worship space and did not need replacing even though the exterior does not look like a church. The Rector and Vestry agreed that a larger church would not be needed until the present building could not accommodate worship even with additional services, and planning shifted to a much-needed new parish hall with offices and classrooms. The Cheek house was demolished in the summer of 1992 to make room for the new building, with offices moved temporarily to the cottage at the rear of the property until the new parish hall was occupied in 1993. Meanwhile, modest improvements were made in the Church: windows over the narthex doors, a new lighting system, and a new stall against the rear screen for choir and organ. The new pipe organ by Visser-Rowland of Houston was installed in February 1993.

On June 28, 1998 Father Stacey held his last service as Rector of St. Andrew's. His pastoral tenure spanned over twelve years and wrought many wonderful changes for the church. His guidance would be missed but the parish had grown under his direction and joyfully undertook the task of finding a new Rector.

After more than a year of meetings and prayer, the people of St. Andrew's welcomed Father James M. Guill as the fourth Rector of St. Andrew's Episcopal Church. Father Guill conducted his first service on St. Mary's Day, August 15, 1999. A native of Memphis, Father Guill earned his B.A. from Vanderbilt and a J.D. from Emory University. He practiced Law for several years before entering the seminary at Nashotah House. Before coming to St. Andrew's of Nashville, Father Guill was an associate pastor at St. Andrew's in Collierville, Tennessee.